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 $575.44 Median $3,388.44 Typical High $6,606.93 | Facility | None | $575.44 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $588.84 | Professional | None | $537.03 | $575.44 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $707.95 | Professional | None | $501.19 | $602.56 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,584.89 | Professional | None | $446.68 | $562.34 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $1,122.02 Typical High $1,318.26 | Professional | None | $549.54 | $1,122.02 | $1,318.26 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $1,584.89 | Professional | None | $416.87 | $758.58 | $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 $263.03 Median $288.40 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $436.52 | Professional | 54 · Surgery only | $398.11 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $407.38 |
Where Washington, DC sits
The same service costs 6.3 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
$603
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.