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 $2,137.96 Typical High $4,073.80 | Facility | None | $398.11 | $2,137.96 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $2,754.23 | Professional | None | $380.19 | $478.63 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $489.78 Typical High $4,073.80 | Professional | None | $147.91 | $489.78 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $426.58 Typical High $7,413.10 | Professional | None | $151.36 | $426.58 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $5,370.32 Typical High $9,549.93 | Professional | None | $1,071.52 | $5,370.32 | $9,549.93 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $154.88 Median $724.44 Typical High $10,232.93 | Professional | None | $154.88 | $724.44 | $10,232.93 |
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 $239.88 Typical High $1,380.38 | Professional | 52 · Reduced service | $190.55 | $239.88 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $549.54 | Professional | 53 · Discontinued | $75.86 | $95.50 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $354.81 Typical High $2,041.74 | Professional | 54 · Surgery only | $288.40 | $354.81 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $70.79 Typical High $416.87 | Professional | 55 · Aftercare only | $57.54 | $70.79 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $275.42 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $331.13 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $269.15 | $331.13 | $1,905.46 |
Where Washington, DC sits
The same service costs 17.4 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· 40th of 51
$501
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.