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 $5,248.07 | Facility | None | $549.54 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,445.44 | Professional | None | $537.03 | $588.84 | $1,445.44 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $1,584.89 | Professional | None | $489.78 | $588.84 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $1,584.89 | Professional | None | $489.78 | $562.34 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,318.26 | Professional | None | $676.08 | $1,258.93 | $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 $457.09 Median $758.58 Typical High $1,513.56 | Professional | None | $457.09 | $758.58 | $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 $263.03 Median $275.42 Typical High $288.40 | Professional | 52 · Reduced service | $263.03 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $389.05 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $87.10 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $407.38 |
Where Washington, DC sits
The same service costs 5.1 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· 38th 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.