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 $489.78 Median $3,090.30 Typical High $5,248.07 | Facility | None | $489.78 | $3,090.30 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,659.59 | Professional | None | $489.78 | $489.78 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $3,715.35 | Professional | None | $371.54 | $416.87 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,071.52 Typical High $3,311.31 | Professional | None | $398.11 | $1,071.52 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $2,754.23 Typical High $2,951.21 | Professional | None | $891.25 | $2,754.23 | $2,951.21 |
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 $363.08 Median $1,202.26 Typical High $3,890.45 | Professional | None | $363.08 | $1,202.26 | $3,890.45 |
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 $245.47 Median $245.47 Typical High $831.76 | Professional | 52 · Reduced service | $245.47 | $245.47 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $331.13 | Professional | 53 · Discontinued | $97.72 | $97.72 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $363.08 Typical High $1,258.93 | Professional | 54 · Surgery only | $363.08 | $363.08 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $251.19 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $165.96 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $338.84 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $338.84 | $338.84 | $1,174.90 |
Where Washington, DC sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$1,288
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.