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 $676.08 Median $2,137.96 Typical High $8,511.38 | Facility | None | $676.08 | $2,137.96 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | None | $616.60 | $676.08 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $691.83 | Professional | None | $549.54 | $602.56 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $1,096.48 | Professional | None | $549.54 | $616.60 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,318.26 | Professional | None | $537.03 | $588.84 | $1,318.26 |
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 $436.52 Median $549.54 Typical High $1,479.11 | Professional | None | $436.52 | $549.54 | $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 $309.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Where Washington, DC sits
The same service costs 5.8 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· 39th of 51
$617
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.