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 $691.83 Median $3,388.44 Typical High $7,079.46 | Facility | None | $691.83 | $3,388.44 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $977.24 | Professional | None | $549.54 | $691.83 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $2,630.27 | Professional | None | $501.19 | $562.34 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $1,995.26 | Professional | None | $489.78 | $660.69 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,778.28 | Professional | None | $812.83 | $1,258.93 | $1,778.28 |
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 $416.87 Median $691.83 Typical High $1,905.46 | Professional | None | $416.87 | $691.83 | $1,905.46 |
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 $316.23 Median $346.74 Typical High $489.78 | Professional | 52 · Reduced service | $316.23 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $194.98 | Professional | 53 · Discontinued | $125.89 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $724.44 | Professional | 54 · Surgery only | $467.74 | $512.86 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $144.54 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $676.08 |
Where Washington, DC sits
The same service costs 4.8 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
$692
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.