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 $1,862.09 Typical High $4,073.80 | Facility | None | $323.59 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | None | $302.00 | $323.59 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $12,302.69 | Professional | None | $323.59 | $354.81 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $870.96 | Professional | None | $275.42 | $295.12 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $758.58 | Professional | None | $331.13 | $630.96 | $758.58 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $891.25 | Professional | None | $234.42 | $416.87 | $891.25 |
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 $151.36 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $151.36 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $66.07 Typical High $70.79 | Professional | 53 · Discontinued | $60.26 | $66.07 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $263.03 | Professional | 54 · Surgery only | $223.87 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $32.36 Typical High $35.48 | Professional | 56 · Pre-op care only | $30.20 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $208.93 | $229.09 | $245.47 |
Where Washington, DC sits
The same service costs 5.8 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· 37th of 51
$355
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.