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 $251.19 Median $3,090.30 Typical High $6,606.93 | Facility | None | $251.19 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $977.24 | Professional | None | $251.19 | $389.05 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $3,235.94 | Professional | None | $239.88 | $263.03 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $676.08 | Professional | None | $239.88 | $363.08 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $891.25 | Professional | None | $416.87 | $588.84 | $891.25 |
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 $213.80 Median $354.81 Typical High $794.33 | Professional | None | $213.80 | $354.81 | $794.33 |
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 $123.03 Median $125.89 Typical High $194.98 | Professional | 52 · Reduced service | $123.03 | $125.89 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $77.62 | Professional | 53 · Discontinued | $48.98 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $295.12 | Professional | 54 · Surgery only | $186.21 | $190.55 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $58.88 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $38.90 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $177.83 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $173.78 | $177.83 | $275.42 |
Where Washington, DC sits
The same service costs 4.8 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
$355
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.