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 $562.34 Median $3,548.13 Typical High $4,786.30 | Facility | None | $562.34 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $691.83 | Professional | None | $537.03 | $562.34 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $6,309.57 | Professional | None | $549.54 | $602.56 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $1,584.89 | Professional | None | $524.81 | $562.34 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $1,122.02 Typical High $1,288.25 | Professional | None | $537.03 | $1,122.02 | $1,288.25 |
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 $457.09 Median $812.83 Typical High $1,584.89 | Professional | None | $457.09 | $812.83 | $1,584.89 |
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 $269.15 Median $281.84 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $120.23 | Professional | 53 · Discontinued | $109.65 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $91.20 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $398.11 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $380.19 | $398.11 | $426.58 |
Where Washington, DC sits
The same service costs 6.8 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
$603
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.