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 $363.08 Median $1,412.54 Typical High $7,943.28 | Facility | None | $363.08 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $467.74 | Professional | None | $354.81 | $363.08 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $645.65 | Professional | None | $354.81 | $407.38 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $977.24 | Professional | None | $346.74 | $436.52 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $851.14 Typical High $1,096.48 | Professional | None | $467.74 | $851.14 | $1,096.48 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $1,071.52 | Professional | None | $323.59 | $467.74 | $1,071.52 |
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 $177.83 Median $181.97 Typical High $234.42 | Professional | 52 · Reduced service | $177.83 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $269.15 Typical High $346.74 | Professional | 54 · Surgery only | $263.03 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $46.77 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $251.19 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $245.47 | $251.19 | $323.59 |
Where Washington, DC sits
The same service costs 6.0 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
$437
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.