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 $371.54 Median $3,311.31 Typical High $7,413.10 | Facility | None | $371.54 | $3,311.31 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $1,071.52 | Professional | None | $371.54 | $426.58 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $3,715.35 | Professional | None | $371.54 | $407.38 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $1,000.00 | Professional | None | $371.54 | $478.63 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $1,000.00 | Professional | None | $446.68 | $467.74 | $1,000.00 |
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 $1,096.48 | Professional | None | $354.81 | $549.54 | $1,096.48 |
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 $186.21 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $74.13 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $281.84 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $38.90 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $263.03 | $269.15 | $302.00 |
Where Washington, DC sits
The same service costs 3.8 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
$447
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.