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 $323.59 Median $3,090.30 Typical High $6,606.93 | Facility | None | $323.59 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $489.78 Typical High $812.83 | Professional | None | $323.59 | $489.78 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $2,630.27 | Professional | None | $316.23 | $346.74 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $1,380.38 | Professional | None | $295.12 | $478.63 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,148.15 | Professional | None | $524.81 | $741.31 | $1,148.15 |
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 $288.40 Median $562.34 Typical High $1,258.93 | Professional | None | $288.40 | $562.34 | $1,258.93 |
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 $162.18 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $245.47 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $354.81 |
Where Washington, DC sits
The same service costs 5.1 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· 32nd of 51
$479
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.