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 $4,073.80 | Facility | None | $501.19 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $870.96 | Professional | None | $489.78 | $724.44 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $2,570.40 | Professional | None | $467.74 | $524.81 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $2,089.30 | Professional | None | $436.52 | $724.44 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,862.09 | Professional | None | $933.25 | $1,148.15 | $1,862.09 |
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 $436.52 Median $891.25 Typical High $1,949.84 | Professional | None | $436.52 | $891.25 | $1,949.84 |
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 $251.19 Median $363.08 Typical High $416.87 | Professional | 52 · Reduced service | $251.19 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $144.54 Typical High $165.96 | Professional | 53 · Discontinued | $100.00 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $549.54 Typical High $616.60 | Professional | 54 · Surgery only | $371.54 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $109.65 Typical High $125.89 | Professional | 55 · Aftercare only | $74.13 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $72.44 Typical High $83.18 | Professional | 56 · Pre-op care only | $50.12 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $512.86 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $346.74 | $512.86 | $575.44 |
Where Washington, DC sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 37th of 51
$724
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.