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 $194.98 Median $4,168.69 Typical High $10,232.93 | Facility | None | $194.98 | $4,168.69 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $831.76 | Professional | None | $194.98 | $269.15 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $4,677.35 | Professional | None | $223.87 | $251.19 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $831.76 Typical High $2,454.71 | Professional | None | $213.80 | $831.76 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $2,187.76 | Professional | None | $977.24 | $1,023.29 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $213.80 Median $645.65 Typical High $2,511.89 | Professional | None | $213.80 | $645.65 | $2,511.89 |
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 $97.72 Median $134.90 Typical High $416.87 | Professional | 52 · Reduced service | $97.72 | $134.90 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $53.70 Typical High $165.96 | Professional | 53 · Discontinued | $38.90 | $53.70 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $204.17 Typical High $630.96 | Professional | 54 · Surgery only | $147.91 | $204.17 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $40.74 Typical High $125.89 | Professional | 55 · Aftercare only | $29.51 | $40.74 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.92 Typical High $83.18 | Professional | 56 · Pre-op care only | $19.50 | $26.92 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $190.55 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $138.04 | $190.55 | $588.84 |
Where Washington, DC sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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· 43rd of 51
$832
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.