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 $1,412.54 Typical High $5,248.07 | Facility | None | $537.03 | $1,412.54 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $1,348.96 | Professional | None | $426.58 | $537.03 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $2,951.21 | Professional | None | $398.11 | $446.68 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,479.11 | Professional | None | $446.68 | $562.34 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $1,000.00 Typical High $1,258.93 | Professional | None | $616.60 | $1,000.00 | $1,258.93 |
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 $398.11 Median $741.31 Typical High $1,380.38 | Professional | None | $398.11 | $741.31 | $1,380.38 |
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 $213.80 Median $213.80 Typical High $269.15 | Professional | 52 · Reduced service | $213.80 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $85.11 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $407.38 | Professional | 54 · Surgery only | $316.23 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $53.70 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $380.19 |
Where Washington, DC sits
The same service costs 5.1 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
$562
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.