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 $380.19 Median $3,311.31 Typical High $7,413.10 | Facility | None | $380.19 | $3,311.31 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $1,096.48 | Professional | None | $380.19 | $436.52 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $3,715.35 | Professional | None | $371.54 | $416.87 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,023.29 | Professional | None | $380.19 | $478.63 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $1,023.29 | Professional | None | $457.09 | $478.63 | $1,023.29 |
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 $354.81 Median $549.54 Typical High $1,122.02 | Professional | None | $354.81 | $549.54 | $1,122.02 |
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 $190.55 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $75.86 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $269.15 | $269.15 | $309.03 |
Where Washington, DC sits
The same service costs 4.3 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· 45th of 51
$437
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.