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 $891.25 Median $5,011.87 Typical High $10,232.93 | Facility | None | $891.25 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $2,238.72 | Professional | None | $851.14 | $891.25 | $2,238.72 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $7,244.36 | Professional | None | $851.14 | $954.99 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $2,454.71 | Professional | None | $812.83 | $870.96 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,737.80 Typical High $2,041.74 | Professional | None | $831.76 | $1,737.80 | $2,041.74 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $2,454.71 | Professional | None | $676.08 | $1,258.93 | $2,454.71 |
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 $416.87 Median $446.68 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $446.68 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $165.96 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $645.65 |
Where Washington, DC sits
The same service costs 7.1 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· 39th of 51
$955
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.