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 $512.86 Median $2,818.38 Typical High $4,786.30 | Facility | None | $512.86 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $1,258.93 | Professional | None | $478.63 | $512.86 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $6,309.57 | Professional | None | $489.78 | $549.54 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $1,412.54 | Professional | None | $457.09 | $501.19 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $977.24 Typical High $1,174.90 | Professional | None | $489.78 | $977.24 | $1,174.90 |
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 $389.05 Median $691.83 Typical High $1,412.54 | Professional | None | $389.05 | $691.83 | $1,412.54 |
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 $239.88 Median $251.19 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $363.08 |
Where Washington, DC sits
The same service costs 6.2 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· 39th of 51
$550
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.