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 $1,698.24 Typical High $4,073.80 | Facility | None | $630.96 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $831.76 | Professional | None | $588.84 | $630.96 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,412.54 | Professional | None | $489.78 | $537.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $1,412.54 | Professional | None | $446.68 | $489.78 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,202.26 | Professional | None | $575.44 | $660.69 | $1,202.26 |
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 $478.63 Median $794.33 Typical High $1,412.54 | Professional | None | $478.63 | $794.33 | $1,412.54 |
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 $288.40 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $114.82 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $478.63 |
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· 35th of 51
$661
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.