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 $190.55 Median $1,698.24 Typical High $4,073.80 | Facility | None | $190.55 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $457.09 Typical High $912.01 | Professional | None | $190.55 | $457.09 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $199.53 Typical High $2,089.30 | Professional | None | $177.83 | $199.53 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $407.38 Typical High $1,174.90 | Professional | None | $177.83 | $407.38 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $1,071.52 | Professional | None | $446.68 | $524.81 | $1,071.52 |
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 $208.93 Median $446.68 Typical High $1,122.02 | Professional | None | $208.93 | $446.68 | $1,122.02 |
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 $95.50 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $95.50 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $38.02 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $144.54 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $28.84 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $40.74 Typical High $46.77 | Professional | 56 · Pre-op care only | $19.05 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $134.90 | $281.84 | $323.59 |
Where Washington, DC sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 28th of 51
$427
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.