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 $562.34 Median $3,090.30 Typical High $6,606.93 | Facility | None | $562.34 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $630.96 | Professional | None | $549.54 | $562.34 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $3,235.94 | Professional | None | $512.86 | $575.44 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,479.11 | Professional | None | $524.81 | $602.56 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $1,479.11 | Professional | None | $676.08 | $1,258.93 | $1,479.11 |
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 $416.87 Median $660.69 Typical High $1,513.56 | Professional | None | $416.87 | $660.69 | $1,513.56 |
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 $275.42 Median $281.84 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $109.65 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $407.38 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $81.28 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $380.19 | $389.05 | $446.68 |
Where Washington, DC sits
The same service costs 5.2 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
$603
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.