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 $524.81 Median $3,548.13 Typical High $4,786.30 | Facility | None | $524.81 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $549.54 | Professional | None | $478.63 | $524.81 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $4,073.80 | Professional | None | $478.63 | $562.34 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $1,445.44 | Professional | None | $501.19 | $512.86 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $1,023.29 Typical High $1,202.26 | Professional | None | $537.03 | $1,023.29 | $1,202.26 |
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 $398.11 Median $741.31 Typical High $1,445.44 | Professional | None | $398.11 | $741.31 | $1,445.44 |
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 $239.88 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $239.88 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $95.50 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $54.95 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $389.05 |
Where Washington, DC sits
The same service costs 8.5 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· 37th 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.