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 $537.03 Median $3,548.13 Typical High $4,786.30 | Facility | None | $537.03 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $562.34 | Professional | None | $457.09 | $537.03 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $3,235.94 | Professional | None | $489.78 | $537.03 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $1,412.54 | Professional | None | $446.68 | $489.78 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,230.27 | Professional | None | $575.44 | $1,047.13 | $1,230.27 |
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 $363.08 Median $676.08 Typical High $1,479.11 | Professional | None | $363.08 | $676.08 | $1,479.11 |
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 $229.09 Median $269.15 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $81.28 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $53.70 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $389.05 |
Where Washington, DC sits
The same service costs 5.5 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· 41st of 51
$537
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.