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 $281.84 Median $1,698.24 Typical High $4,786.30 | Facility | None | $281.84 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $707.95 | Professional | None | $245.47 | $457.09 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $2,089.30 | Professional | None | $208.93 | $229.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $912.01 | Professional | None | $208.93 | $346.74 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $912.01 | Professional | None | $407.38 | $524.81 | $912.01 |
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 $199.53 Median $371.54 Typical High $1,023.29 | Professional | None | $199.53 | $371.54 | $1,023.29 |
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 $131.83 Median $141.25 Typical High $251.19 | Professional | 52 · Reduced service | $131.83 | $141.25 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $56.23 Typical High $100.00 | Professional | 53 · Discontinued | $52.48 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $371.54 | Professional | 54 · Surgery only | $199.53 | $213.80 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $42.66 Typical High $74.13 | Professional | 55 · Aftercare only | $39.81 | $42.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.18 Typical High $50.12 | Professional | 56 · Pre-op care only | $26.30 | $28.18 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $199.53 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $186.21 | $199.53 | $346.74 |
Where Washington, DC sits
The same service costs 4.3 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· 44th of 51
$355
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.