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 $489.78 Median $2,818.38 Typical High $4,786.30 | Facility | None | $489.78 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $562.34 | Professional | None | $407.38 | $489.78 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $2,570.40 | Professional | None | $363.08 | $407.38 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $1,174.90 | Professional | None | $346.74 | $407.38 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $1,000.00 | Professional | None | $478.63 | $549.54 | $1,000.00 |
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 $295.12 Median $416.87 Typical High $1,096.48 | Professional | None | $295.12 | $416.87 | $1,096.48 |
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 $204.17 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $204.17 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $81.28 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $302.00 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $60.26 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $40.74 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $281.84 | $346.74 | $398.11 |
Where Washington, DC sits
The same service costs 6.0 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· 39th 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.