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 $436.52 Median $1,737.80 Typical High $6,456.54 | Facility | None | $436.52 | $1,737.80 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $1,096.48 | Professional | None | $426.58 | $588.84 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $5,128.61 | Professional | None | $426.58 | $467.74 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $1,737.80 | Professional | None | $389.05 | $602.56 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,445.44 | Professional | None | $676.08 | $1,000.00 | $1,445.44 |
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 $371.54 Median $724.44 Typical High $1,584.89 | Professional | None | $371.54 | $724.44 | $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 $218.78 Median $269.15 Typical High $316.23 | Professional | 52 · Reduced service | $218.78 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $107.15 Typical High $125.89 | Professional | 53 · Discontinued | $87.10 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $398.11 Typical High $478.63 | Professional | 54 · Surgery only | $323.59 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $63.10 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $371.54 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $302.00 | $371.54 | $446.68 |
Where Washington, DC sits
The same service costs 4.6 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· 34th 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.