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 $537.03 Median $4,073.80 Typical High $7,079.46 | Facility | None | $537.03 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,318.26 | Professional | None | $489.78 | $537.03 | $1,318.26 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $575.44 Typical High $2,951.21 | Professional | None | $338.84 | $575.44 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $1,479.11 | Professional | None | $467.74 | $512.86 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $1,023.29 Typical High $1,230.27 | Professional | None | $524.81 | $1,023.29 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $380.19 Median $676.08 Typical High $1,479.11 | Professional | None | $380.19 | $676.08 | $1,479.11 |
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 $234.42 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $380.19 | $380.19 |
Where Washington, DC sits
The same service costs 6.9 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· 33rd of 51
$575
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.