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 $630.96 Median $3,388.44 Typical High $7,079.46 | Facility | None | $630.96 | $3,388.44 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $630.96 Typical High $776.25 | Professional | None | $616.60 | $630.96 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $4,466.84 | Professional | None | $549.54 | $660.69 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $2,137.96 | Professional | None | $630.96 | $812.83 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $1,819.70 | Professional | None | $870.96 | $1,445.44 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,995.26 | Professional | None | $588.84 | $1,122.02 | $1,995.26 |
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 $309.03 Median $316.23 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $123.03 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $549.54 |
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· 41st of 51
$776
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.