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 $1,698.24 Typical High $5,248.07 | Facility | None | $691.83 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,698.24 | Professional | None | $467.74 | $691.83 | $1,698.24 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $3,235.94 | Professional | None | $467.74 | $512.86 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $1,905.46 | Professional | None | $436.52 | $660.69 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,584.89 | Professional | None | $741.31 | $1,122.02 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $1,698.24 | Professional | None | $416.87 | $794.33 | $1,698.24 |
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 $245.47 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $245.47 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $97.72 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $363.08 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $338.84 | $407.38 | $489.78 |
Where Washington, DC sits
The same service costs 5.0 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· 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.