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 $977.24 Median $3,981.07 Typical High $7,413.10 | Facility | None | $977.24 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,023.29 | Professional | None | $912.01 | $977.24 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $6,309.57 | Professional | None | $933.25 | $1,047.13 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $2,691.53 | Professional | None | $891.25 | $977.24 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,949.84 Typical High $2,238.72 | Professional | None | $912.01 | $1,949.84 | $2,238.72 |
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 $741.31 Median $1,380.38 Typical High $2,754.23 | Professional | None | $741.31 | $1,380.38 | $2,754.23 |
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 $457.09 Median $489.78 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $691.83 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $724.44 |
Where Washington, DC sits
The same service costs 7.9 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
$1,047
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.