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 $416.87 Median $1,698.24 Typical High $5,248.07 | Facility | None | $416.87 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $602.56 Typical High $1,230.27 | Professional | None | $416.87 | $602.56 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $2,630.27 | Professional | None | $407.38 | $446.68 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $1,621.81 | Professional | None | $380.19 | $575.44 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $954.99 Typical High $1,380.38 | Professional | None | $630.96 | $954.99 | $1,380.38 |
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 $380.19 Median $691.83 Typical High $1,479.11 | Professional | None | $380.19 | $691.83 | $1,479.11 |
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 $208.93 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $208.93 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $83.18 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $309.03 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $41.69 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $363.08 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $288.40 | $363.08 | $416.87 |
Where Washington, DC sits
The same service costs 5.6 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· 32nd 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.