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 $676.08 Median $1,659.59 Typical High $7,943.28 | Facility | None | $676.08 | $1,659.59 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $1,659.59 | Professional | None | $645.65 | $676.08 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $8,912.51 | Professional | None | $676.08 | $758.58 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $1,819.70 | Professional | None | $630.96 | $660.69 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $1,348.96 Typical High $1,513.56 | Professional | None | $630.96 | $1,348.96 | $1,513.56 |
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 $524.81 Median $954.99 Typical High $1,862.09 | Professional | None | $524.81 | $954.99 | $1,862.09 |
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 $309.03 Median $331.13 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $331.13 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $501.19 |
Where Washington, DC sits
The same service costs 7.1 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· 36th of 51
$759
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.