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 $467.74 Median $1,737.80 Typical High $5,248.07 | Facility | None | $467.74 | $1,737.80 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,479.11 | Professional | None | $467.74 | $588.84 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $3,715.35 | Professional | None | $436.52 | $489.78 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $1,621.81 | Professional | None | $489.78 | $616.60 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,380.38 | Professional | None | $676.08 | $1,096.48 | $1,380.38 |
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 $436.52 Median $812.83 Typical High $1,513.56 | Professional | None | $436.52 | $812.83 | $1,513.56 |
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 $234.42 Median $234.42 Typical High $295.12 | Professional | 52 · Reduced service | $234.42 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $117.49 | Professional | 53 · Discontinued | $93.33 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | 54 · Surgery only | $354.81 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $58.88 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $416.87 |
Where Washington, DC sits
The same service costs 4.9 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· 42nd of 51
$589
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.