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 $446.68 Median $2,818.38 Typical High $4,786.30 | Facility | None | $446.68 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $467.74 | Professional | None | $416.87 | $446.68 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $3,235.94 | Professional | None | $398.11 | $446.68 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $1,174.90 | Professional | None | $380.19 | $407.38 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $831.76 Typical High $1,023.29 | Professional | None | $436.52 | $831.76 | $1,023.29 |
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 $323.59 Median $549.54 Typical High $1,230.27 | Professional | None | $323.59 | $549.54 | $1,230.27 |
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 $208.93 Median $223.87 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $309.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $316.23 |
Where Washington, DC sits
The same service costs 5.9 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· 40th of 51
$447
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.