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 $416.87 Median $3,388.44 Typical High $6,606.93 | Facility | None | $416.87 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $446.68 | Professional | None | $389.05 | $416.87 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $2,630.27 | Professional | None | $363.08 | $426.58 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $1,122.02 | Professional | None | $363.08 | $389.05 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $831.76 Typical High $977.24 | Professional | None | $416.87 | $831.76 | $977.24 |
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 $309.03 Median $537.03 Typical High $1,174.90 | Professional | None | $309.03 | $537.03 | $1,174.90 |
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 $194.98 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $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· 38th 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.