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 $457.09 Median $1,698.24 Typical High $4,073.80 | Facility | None | $457.09 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | None | $416.87 | $457.09 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $1,380.38 | Professional | None | $389.05 | $489.78 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $1,380.38 | Professional | None | $389.05 | $489.78 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,174.90 | Professional | None | $562.34 | $1,047.13 | $1,174.90 |
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 $331.13 Median $616.60 Typical High $1,288.25 | Professional | None | $331.13 | $616.60 | $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 $213.80 Median $229.09 Typical High $251.19 | Professional | 52 · Reduced service | $213.80 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $380.19 | Professional | 54 · Surgery only | $323.59 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $75.86 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $354.81 |
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
$490
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.