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 $398.11 Median $2,818.38 Typical High $4,786.30 | Facility | None | $398.11 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $398.11 Typical High $1,000.00 | Professional | None | $380.19 | $398.11 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $5,011.87 | Professional | None | $363.08 | $407.38 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $1,047.13 | Professional | None | $354.81 | $363.08 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $776.25 Typical High $912.01 | Professional | None | $389.05 | $776.25 | $912.01 |
United Setting Facility Modifier None Typical Low $14,791.08 Median $27,542.29 Typical High $70,794.58 | Facility | None | $14,791.08 | $27,542.29 | $70,794.58 |
United Setting Professional Modifier None Typical Low $316.23 Median $512.86 Typical High $1,096.48 | Professional | None | $316.23 | $512.86 | $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 $190.55 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $295.12 Typical High $323.59 | Professional | 54 · Surgery only | $288.40 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $58.88 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $275.42 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $269.15 | $275.42 | $302.00 |
Where Washington, DC sits
The same service costs 5.6 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· 44th 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.