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 $3,548.13 Typical High $4,786.30 | Facility | None | $549.54 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $660.69 | Professional | None | $512.86 | $549.54 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $707.95 | Professional | None | $537.03 | $588.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,513.56 | Professional | None | $524.81 | $549.54 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $1,096.48 Typical High $1,258.93 | Professional | None | $524.81 | $1,096.48 | $1,258.93 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,548.82 | Professional | None | $501.19 | $776.25 | $1,548.82 |
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 $257.04 Median $275.42 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $457.09 |
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· 42nd 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.