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 $269.15 Median $1,698.24 Typical High $4,786.30 | Facility | None | $269.15 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $954.99 | Professional | None | $269.15 | $398.11 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $2,089.30 | Professional | None | $229.09 | $251.19 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $398.11 Typical High $977.24 | Professional | None | $245.47 | $398.11 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $398.11 Typical High $776.25 | Professional | None | $371.54 | $398.11 | $776.25 |
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 $213.80 Median $478.63 Typical High $1,000.00 | Professional | None | $213.80 | $478.63 | $1,000.00 |
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 $134.90 Median $134.90 Typical High $199.53 | Professional | 52 · Reduced service | $134.90 | $134.90 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $81.28 | Professional | 53 · Discontinued | $53.70 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $302.00 | Professional | 54 · Surgery only | $199.53 | $199.53 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $60.26 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $39.81 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $281.84 |
Where Washington, DC sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 37th of 51
$398
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.