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 $741.31 Median $3,388.44 Typical High $6,606.93 | Facility | None | $741.31 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $741.31 | Professional | None | $676.08 | $741.31 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $812.83 | Professional | None | $630.96 | $707.95 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,202.26 | Professional | None | $616.60 | $676.08 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $1,445.44 | Professional | None | $562.34 | $630.96 | $1,445.44 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,621.81 | Professional | None | $501.19 | $616.60 | $1,621.81 |
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 $346.74 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $512.86 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $524.81 |
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· 34th of 51
$708
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.