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 $2,089.30 Typical High $4,265.80 | Facility | None | $870.96 | $2,089.30 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $1,584.89 | Professional | None | $630.96 | $870.96 | $1,584.89 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $6,309.57 | Professional | None | $616.60 | $676.08 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $2,398.83 | Professional | None | $562.34 | $831.76 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $1,995.26 | Professional | None | $933.25 | $1,445.44 | $1,995.26 |
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 $537.03 Median $1,023.29 Typical High $2,137.96 | Professional | None | $537.03 | $1,023.29 | $2,137.96 |
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 $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $316.23 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $125.89 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $467.74 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $616.60 |
Where Washington, DC sits
The same service costs 5.2 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
$871
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.