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 $691.83 Median $2,137.96 Typical High $6,456.54 | Facility | None | $691.83 | $2,137.96 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $2,137.96 | Professional | None | $691.83 | $870.96 | $2,137.96 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $4,677.35 | Professional | None | $645.65 | $724.44 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $2,344.23 | Professional | None | $724.44 | $977.24 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $1,995.26 | Professional | None | $954.99 | $1,584.89 | $1,995.26 |
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 $645.65 Median $1,202.26 Typical High $2,187.76 | Professional | None | $645.65 | $1,202.26 | $2,187.76 |
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 $338.84 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $134.90 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $602.56 |
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· 37th of 51
$891
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.