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 $426.58 Median $3,090.30 Typical High $6,606.93 | Facility | None | $426.58 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $575.44 Typical High $1,047.13 | Professional | None | $398.11 | $575.44 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $3,235.94 | Professional | None | $380.19 | $446.68 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $1,621.81 | Professional | None | $380.19 | $562.34 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $977.24 Typical High $1,380.38 | Professional | None | $616.60 | $977.24 | $1,380.38 |
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 $354.81 Median $676.08 Typical High $1,479.11 | Professional | None | $354.81 | $676.08 | $1,479.11 |
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 $204.17 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $204.17 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $81.28 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $309.03 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $416.87 |
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· 33rd of 51
$562
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.