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 $660.69 Median $3,090.30 Typical High $6,606.93 | Facility | None | $660.69 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,698.24 | Professional | None | $588.84 | $660.69 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $2,630.27 | Professional | None | $616.60 | $676.08 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,778.28 | Professional | None | $562.34 | $616.60 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $1,479.11 | Professional | None | $660.69 | $1,174.90 | $1,479.11 |
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 $851.14 Typical High $1,819.70 | Professional | None | $446.68 | $851.14 | $1,819.70 |
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 $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $58.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $467.74 |
Where Washington, DC sits
The same service costs 6.8 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
$676
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.