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 $537.03 Median $1,318.26 Typical High $3,311.31 | Facility | None | $537.03 | $1,318.26 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $1,318.26 | Professional | None | $363.08 | $537.03 | $1,318.26 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $2,570.40 | Professional | None | $288.40 | $346.74 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $1,288.25 | Professional | None | $354.81 | $501.19 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $1,148.15 | Professional | None | $512.86 | $794.33 | $1,148.15 |
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 $309.03 Median $616.60 Typical High $1,258.93 | Professional | None | $309.03 | $616.60 | $1,258.93 |
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 $181.97 Median $181.97 Typical High $269.15 | Professional | 52 · Reduced service | $181.97 | $181.97 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $107.15 | Professional | 53 · Discontinued | $72.44 | $72.44 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $398.11 | Professional | 54 · Surgery only | $269.15 | $275.42 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $79.43 | Professional | 55 · Aftercare only | $53.70 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $53.70 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $257.04 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $251.19 | $257.04 | $371.54 |
Where Washington, DC sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 24th of 51
$537
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.