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 $3,090.30 Typical High $6,606.93 | Facility | None | $741.31 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $1,862.09 | Professional | None | $707.95 | $741.31 | $1,862.09 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $3,235.94 | Professional | None | $707.95 | $794.33 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,995.26 | Professional | None | $660.69 | $691.83 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,479.11 Typical High $1,698.24 | Professional | None | $707.95 | $1,479.11 | $1,698.24 |
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 $562.34 Median $977.24 Typical High $2,041.74 | Professional | None | $562.34 | $977.24 | $2,041.74 |
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 $354.81 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $354.81 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $575.44 |
Where Washington, DC sits
The same service costs 5.9 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· 38th of 51
$794
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.