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 $489.78 Median $5,011.87 Typical High $10,232.93 | Facility | None | $489.78 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $489.78 | Professional | None | $457.09 | $489.78 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $2,951.21 | Professional | None | $467.74 | $512.86 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $1,348.96 | Professional | None | $426.58 | $478.63 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $933.25 Typical High $1,122.02 | Professional | None | $467.74 | $933.25 | $1,122.02 |
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 $346.74 Median $660.69 Typical High $1,348.96 | Professional | None | $346.74 | $660.69 | $1,348.96 |
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 $223.87 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $338.84 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $346.74 |
Where Washington, DC sits
The same service costs 6.6 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· 40th of 51
$513
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.