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 $416.87 Median $4,073.80 Typical High $7,079.46 | Facility | None | $416.87 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | None | $398.11 | $416.87 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $630.96 | Professional | None | $363.08 | $446.68 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $1,148.15 | Professional | None | $380.19 | $407.38 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $812.83 Typical High $954.99 | Professional | None | $380.19 | $812.83 | $954.99 |
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 $316.23 Median $562.34 Typical High $1,148.15 | Professional | None | $316.23 | $562.34 | $1,148.15 |
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 $194.98 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $79.43 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $295.12 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $58.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $295.12 |
Where Washington, DC sits
The same service costs 6.5 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· 39th of 51
$447
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.