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 $870.96 Median $3,090.30 Typical High $6,606.93 | Facility | None | $870.96 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,122.02 | Professional | None | $851.14 | $954.99 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $4,073.80 | Professional | None | $831.76 | $933.25 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $3,019.95 | Professional | None | $794.33 | $1,071.52 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,995.26 | $2,570.40 |
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 $741.31 Median $1,318.26 Typical High $2,754.23 | Professional | None | $741.31 | $1,318.26 | $2,754.23 |
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 $426.58 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $426.58 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $169.82 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $645.65 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $602.56 | $724.44 | $776.25 |
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· 34th of 51
$1,072
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.