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 $512.86 Median $3,090.30 Typical High $6,606.93 | Facility | None | $512.86 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $645.65 | Professional | None | $501.19 | $588.84 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $7,943.28 | Professional | None | $501.19 | $549.54 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,737.80 | Professional | None | $467.74 | $616.60 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,174.90 Typical High $1,479.11 | Professional | None | $707.95 | $1,174.90 | $1,479.11 |
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 $776.25 Typical High $1,584.89 | Professional | None | $436.52 | $776.25 | $1,584.89 |
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 $251.19 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $446.68 |
Where Washington, DC sits
The same service costs 5.2 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· 34th of 51
$617
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.