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 $501.19 Median $1,698.24 Typical High $7,943.28 | Facility | None | $501.19 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | None | $436.52 | $501.19 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $501.19 | Professional | None | $416.87 | $467.74 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $794.33 | Professional | None | $416.87 | $446.68 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $851.14 | Professional | None | $354.81 | $389.05 | $851.14 |
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 $338.84 Median $389.05 Typical High $1,096.48 | Professional | None | $338.84 | $389.05 | $1,096.48 |
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 $234.42 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $323.59 | $346.74 | $346.74 |
Where Washington, DC sits
The same service costs 5.0 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· 35th of 51
$468
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.