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 $489.78 | Professional | None | $354.81 | $363.08 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $1,380.38 | Professional | None | $302.00 | $380.19 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $1,000.00 | Professional | None | $346.74 | $467.74 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $1,148.15 | Professional | None | $501.19 | $851.14 | $1,148.15 |
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 $302.00 Median $467.74 Typical High $1,071.52 | Professional | None | $302.00 | $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 $245.47 | Professional | 52 · Reduced service | $177.83 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $97.72 | Professional | 53 · Discontinued | $70.79 | $72.44 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $371.54 | Professional | 54 · Surgery only | $263.03 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $74.13 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $48.98 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $245.47 | $257.04 | $346.74 |
Where Washington, DC sits
The same service costs 4.7 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· 34th 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.