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 $512.86 Median $3,388.44 Typical High $7,079.46 | Facility | None | $512.86 | $3,388.44 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $588.84 | Professional | None | $416.87 | $512.86 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $1,412.54 | Professional | None | $380.19 | $416.87 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $1,230.27 | Professional | None | $363.08 | $426.58 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,047.13 | Professional | None | $489.78 | $575.44 | $1,047.13 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $1,148.15 | Professional | None | $302.00 | $426.58 | $1,148.15 |
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 $257.04 Typical High $295.12 | Professional | 52 · Reduced service | $208.93 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $102.33 Typical High $117.49 | Professional | 53 · Discontinued | $83.18 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $389.05 Typical High $436.52 | Professional | 54 · Surgery only | $309.03 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $87.10 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $51.29 Typical High $58.88 | Professional | 56 · Pre-op care only | $41.69 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $363.08 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $288.40 | $363.08 | $407.38 |
Where Washington, DC sits
The same service costs 5.6 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
$468
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.