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 $676.08 Median $2,137.96 Typical High $4,786.30 | Facility | None | $676.08 | $2,137.96 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $676.08 Typical High $1,659.59 | Professional | None | $645.65 | $676.08 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $9,772.37 | Professional | None | $645.65 | $724.44 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,862.09 | Professional | None | $616.60 | $660.69 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,318.26 Typical High $1,548.82 | Professional | None | $645.65 | $1,318.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $1,862.09 | Professional | None | $524.81 | $954.99 | $1,862.09 |
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 $316.23 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $316.23 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $489.78 |
Where Washington, DC sits
The same service costs 7.1 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· 38th of 51
$724
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.