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 $549.54 Median $1,698.24 Typical High $4,073.80 | Facility | None | $549.54 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $602.56 | Professional | None | $512.86 | $549.54 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $1,380.38 | Professional | None | $467.74 | $588.84 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,621.81 | Professional | None | $467.74 | $575.44 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $1,258.93 Typical High $1,380.38 | Professional | None | $660.69 | $1,258.93 | $1,380.38 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $1,513.56 | Professional | None | $416.87 | $741.31 | $1,513.56 |
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 $257.04 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $416.87 |
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
$589
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.