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 $691.83 Median $4,073.80 Typical High $7,079.46 | Facility | None | $691.83 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,698.24 | Professional | None | $575.44 | $691.83 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $2,951.21 | Professional | None | $630.96 | $707.95 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,819.70 | Professional | None | $562.34 | $630.96 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,202.26 Typical High $1,548.82 | Professional | None | $676.08 | $1,202.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $446.68 Median $870.96 Typical High $1,862.09 | Professional | None | $446.68 | $870.96 | $1,862.09 |
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 $295.12 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $478.63 | $478.63 |
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· 35th of 51
$708
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.