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 $3,090.30 Typical High $6,606.93 | Facility | None | $436.52 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $630.96 | Professional | None | $436.52 | $549.54 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $7,943.28 | Professional | None | $426.58 | $478.63 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,698.24 | Professional | None | $398.11 | $602.56 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,412.54 | Professional | None | $645.65 | $1,000.00 | $1,412.54 |
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 $407.38 Median $741.31 Typical High $1,548.82 | Professional | None | $407.38 | $741.31 | $1,548.82 |
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 $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $218.78 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $89.13 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $331.13 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $436.52 |
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· 35th 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.