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 $1,023.29 Median $2,454.71 Typical High $5,248.07 | Facility | None | $1,023.29 | $2,454.71 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $2,041.74 | Professional | None | $812.83 | $1,023.29 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $2,344.23 | Professional | None | $776.25 | $851.14 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $2,238.72 | Professional | None | $776.25 | $977.24 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,905.46 | $2,398.83 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $2,238.72 | Professional | None | $724.44 | $1,047.13 | $2,238.72 |
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 $407.38 Median $416.87 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $616.60 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $154.88 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $707.95 |
Where Washington, DC sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 36th of 51
$1,000
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.