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 $741.31 Median $4,073.80 Typical High $8,511.38 | Facility | None | $741.31 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,862.09 | Professional | None | $676.08 | $741.31 | $1,862.09 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $15,848.93 | Professional | None | $776.25 | $870.96 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $2,041.74 | Professional | None | $645.65 | $741.31 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $1,698.24 | Professional | None | $724.44 | $1,445.44 | $1,698.24 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $2,089.30 | Professional | None | $537.03 | $1,000.00 | $2,089.30 |
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 $338.84 Median $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $100.00 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $524.81 | $537.03 |
Where Washington, DC sits
The same service costs 7.6 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
$871
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.