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 $1,047.13 Median $2,137.96 Typical High $7,413.10 | Facility | None | $1,047.13 | $2,137.96 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,047.13 | Professional | None | $602.56 | $741.31 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $2,630.27 | Professional | None | $549.54 | $616.60 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $2,137.96 | Professional | None | $537.03 | $741.31 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,380.38 Typical High $1,905.46 | Professional | None | $851.14 | $1,380.38 | $1,905.46 |
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 $446.68 Median $741.31 Typical High $1,995.26 | Professional | None | $446.68 | $741.31 | $1,995.26 |
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 $331.13 Median $371.54 Typical High $524.81 | Professional | 52 · Reduced service | $331.13 | $371.54 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $208.93 | Professional | 53 · Discontinued | $131.83 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $489.78 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $154.88 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $724.44 |
Where Washington, DC sits
The same service costs 4.6 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· 39th of 51
$741
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.