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 $630.96 Median $3,311.31 Typical High $7,413.10 | Facility | None | $630.96 | $3,311.31 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $891.25 | Professional | None | $537.03 | $630.96 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,380.38 | Professional | None | $489.78 | $537.03 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $1,380.38 | Professional | None | $446.68 | $478.63 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,174.90 | Professional | None | $549.54 | $645.65 | $1,174.90 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,380.38 | Professional | None | $467.74 | $575.44 | $1,380.38 |
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 $281.84 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $281.84 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $112.20 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $416.87 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $95.50 Typical High $97.72 | Professional | 55 · Aftercare only | $83.18 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $66.07 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $389.05 | $446.68 | $457.09 |
Where Washington, DC sits
The same service costs 6.2 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· 33rd of 51
$603
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.