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 $691.83 Median $3,388.44 Typical High $7,079.46 | Facility | None | $691.83 | $3,388.44 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | None | $630.96 | $691.83 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $724.44 | Professional | None | $562.34 | $630.96 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,122.02 | Professional | None | $562.34 | $630.96 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,348.96 | Professional | None | $537.03 | $602.56 | $1,348.96 |
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 $446.68 Median $562.34 Typical High $1,513.56 | Professional | None | $446.68 | $562.34 | $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 $323.59 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $489.78 |
Where Washington, DC sits
The same service costs 5.5 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
$631
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.