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 $851.14 Median $2,570.40 Typical High $4,786.30 | Facility | None | $851.14 | $2,570.40 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $2,137.96 | Professional | None | $851.14 | $1,023.29 | $2,137.96 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $2,089.30 | Professional | None | $794.33 | $891.25 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $2,290.87 | Professional | None | $812.83 | $977.24 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,071.52 | $2,089.30 | $2,754.23 |
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 $676.08 Median $1,047.13 Typical High $2,290.87 | Professional | None | $676.08 | $1,047.13 | $2,290.87 |
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 $416.87 Median $426.58 Typical High $512.86 | Professional | 52 · Reduced service | $416.87 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $165.96 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $83.18 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $602.56 | $724.44 |
Where Washington, DC sits
The same service costs 4.4 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· 32nd 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.