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 $354.81 Median $1,698.24 Typical High $4,073.80 | Facility | None | $354.81 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $707.95 | Professional | None | $346.74 | $549.54 | $707.95 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $2,089.30 | Professional | None | $331.13 | $371.54 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $1,621.81 | Professional | None | $331.13 | $562.34 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,348.96 | Professional | None | $645.65 | $812.83 | $1,348.96 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $309.03 Median $660.69 Typical High $1,479.11 | Professional | None | $309.03 | $660.69 | $1,479.11 |
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 $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $177.83 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $70.79 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $269.15 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $53.70 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $35.48 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $251.19 | $354.81 | $416.87 |
Where Washington, DC sits
The same service costs 3.4 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· 30th of 51
$562
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.