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 $724.44 Median $4,073.80 Typical High $7,079.46 | Facility | None | $724.44 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | None | $660.69 | $724.44 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $4,570.88 | Professional | None | $676.08 | $758.58 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,949.84 | Professional | None | $676.08 | $741.31 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,380.38 Typical High $1,621.81 | Professional | None | $676.08 | $1,380.38 | $1,621.81 |
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 $588.84 Median $954.99 Typical High $1,949.84 | Professional | None | $588.84 | $954.99 | $1,949.84 |
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 $331.13 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $112.20 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $524.81 |
Where Washington, DC sits
The same service costs 8.1 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· 35th of 51
$759
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.