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 $562.34 Median $3,388.44 Typical High $7,079.46 | Facility | None | $562.34 | $3,388.44 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $707.95 | Professional | None | $467.74 | $562.34 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $2,137.96 | Professional | None | $407.38 | $457.09 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $1,479.11 | Professional | None | $389.05 | $512.86 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,318.26 | Professional | None | $602.56 | $1,023.29 | $1,318.26 |
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 $338.84 Median $512.86 Typical High $1,380.38 | Professional | None | $338.84 | $512.86 | $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 $234.42 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $112.20 Typical High $144.54 | Professional | 53 · Discontinued | $95.50 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $537.03 | Professional | 54 · Surgery only | $354.81 | $416.87 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $389.05 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $331.13 | $389.05 | $501.19 |
Where Washington, DC sits
The same service costs 6.5 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· 40th of 51
$525
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.