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 $489.78 Median $2,818.38 Typical High $4,786.30 | Facility | None | $489.78 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $1,202.26 | Professional | None | $467.74 | $489.78 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $5,011.87 | Professional | None | $467.74 | $524.81 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $1,348.96 | Professional | None | $457.09 | $489.78 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $954.99 Typical High $1,122.02 | Professional | None | $467.74 | $954.99 | $1,122.02 |
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 $389.05 Median $691.83 Typical High $1,380.38 | Professional | None | $389.05 | $691.83 | $1,380.38 |
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 $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $234.42 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $93.33 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $346.74 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $363.08 |
Where Washington, DC sits
The same service costs 6.0 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· 40th of 51
$525
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.