How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $407.38 Median $1,698.24 Typical High $4,786.30 | Facility | None | $407.38 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $575.44 | Professional | None | $380.19 | $457.09 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $416.87 | Professional | None | $331.13 | $363.08 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $446.68 Typical High $794.33 | Professional | None | $331.13 | $446.68 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $1,122.02 | Professional | None | $512.86 | $575.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $954.99 | Professional | None | $257.04 | $398.11 | $954.99 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $204.17 Typical High $288.40 | Professional | 52 · Reduced service | $194.98 | $204.17 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $117.49 | Professional | 53 · Discontinued | $77.62 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $436.52 | Professional | 54 · Surgery only | $288.40 | $302.00 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $57.54 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $57.54 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $407.38 |
Where Washington, DC sits
The same service costs 4.0 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Washington, DC· 40th of 51
$407
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.