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 $323.59 Median $2,137.96 Typical High $4,073.80 | Facility | None | $323.59 | $2,137.96 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $776.25 Typical High $2,818.38 | Professional | None | $223.87 | $776.25 | $2,818.38 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $338.84 Typical High $5,754.40 | Professional | None | $123.03 | $338.84 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $331.13 Typical High $5,754.40 | Professional | None | $131.83 | $331.13 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $2,570.40 Typical High $5,248.07 | Professional | None | $741.31 | $2,570.40 | $5,248.07 |
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 $151.36 Median $660.69 Typical High $5,495.41 | Professional | None | $151.36 | $660.69 | $5,495.41 |
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 $162.18 Median $223.87 Typical High $1,174.90 | Professional | 52 · Reduced service | $162.18 | $223.87 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $89.13 Typical High $467.74 | Professional | 53 · Discontinued | $64.57 | $89.13 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $331.13 Typical High $1,778.28 | Professional | 54 · Surgery only | $245.47 | $331.13 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $354.81 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $234.42 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $309.03 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $229.09 | $309.03 | $1,659.59 |
Where Washington, DC sits
The same service costs 13.5 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· 37th of 51
$457
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.