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 $741.31 Median $3,090.30 Typical High $6,606.93 | Facility | None | $741.31 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $933.25 | Professional | None | $741.31 | $794.33 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $3,235.94 | Professional | None | $691.83 | $758.58 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,995.26 | Professional | None | $691.83 | $870.96 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,737.80 | $2,187.76 |
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 $602.56 Median $933.25 Typical High $2,041.74 | Professional | None | $602.56 | $933.25 | $2,041.74 |
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 $363.08 Median $371.54 Typical High $467.74 | Professional | 52 · Reduced service | $363.08 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $562.34 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $660.69 |
Where Washington, DC sits
The same service costs 4.6 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· 38th of 51
$871
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.