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 $416.87 Median $1,698.24 Typical High $5,248.07 | Facility | None | $416.87 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $630.96 | Professional | None | $407.38 | $512.86 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | None | $338.84 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $870.96 | Professional | None | $363.08 | $501.19 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,202.26 | Professional | None | $562.34 | $630.96 | $1,202.26 |
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 $288.40 Median $436.52 Typical High $1,023.29 | Professional | None | $288.40 | $436.52 | $1,023.29 |
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 $204.17 Median $213.80 Typical High $316.23 | Professional | 52 · Reduced service | $204.17 | $213.80 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $125.89 | Professional | 53 · Discontinued | $81.28 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $316.23 Typical High $478.63 | Professional | 54 · Surgery only | $302.00 | $316.23 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $95.50 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $63.10 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $295.12 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $281.84 | $295.12 | $446.68 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 48th of 51
$417
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.