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 $549.54 Median $3,388.44 Typical High $6,606.93 | Facility | None | $549.54 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,348.96 | Professional | None | $512.86 | $549.54 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $4,073.80 | Professional | None | $524.81 | $575.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,513.56 | Professional | None | $489.78 | $537.03 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $1,071.52 Typical High $1,230.27 | Professional | None | $524.81 | $1,071.52 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $398.11 Median $758.58 Typical High $1,513.56 | Professional | None | $398.11 | $758.58 | $1,513.56 |
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 $251.19 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $416.87 | Professional | 54 · Surgery only | $380.19 | $407.38 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $83.18 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $389.05 |
Where Washington, DC sits
The same service costs 6.6 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· 40th of 51
$575
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.