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 $467.74 Median $3,388.44 Typical High $6,606.93 | Facility | None | $467.74 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $1,122.02 | Professional | None | $436.52 | $467.74 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $3,235.94 | Professional | None | $446.68 | $501.19 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $457.09 Typical High $1,288.25 | Professional | None | $436.52 | $457.09 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $891.25 Typical High $1,071.52 | Professional | None | $436.52 | $891.25 | $1,071.52 |
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 $407.38 Median $645.65 Typical High $1,288.25 | Professional | None | $407.38 | $645.65 | $1,288.25 |
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 $218.78 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $218.78 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $87.10 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $407.38 | Professional | 54 · Surgery only | $323.59 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $380.19 |
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· 40th of 51
$501
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.