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 $346.74 Median $3,090.30 Typical High $6,606.93 | Facility | None | $346.74 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $549.54 | Professional | None | $331.13 | $457.09 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $363.08 Typical High $3,235.94 | Professional | None | $245.47 | $363.08 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $1,479.11 | Professional | None | $295.12 | $512.86 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,230.27 | Professional | None | $602.56 | $794.33 | $1,230.27 |
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 $269.15 Median $602.56 Typical High $1,348.96 | Professional | None | $269.15 | $602.56 | $1,348.96 |
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 $165.96 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $165.96 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $66.07 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $251.19 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $50.12 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $45.71 Typical High $54.95 | Professional | 56 · Pre-op care only | $33.11 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $316.23 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $234.42 | $316.23 | $389.05 |
Where Washington, DC sits
The same service costs 5.1 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· 28th of 51
$501
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.