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 $851.14 Median $4,073.80 Typical High $7,079.46 | Facility | None | $851.14 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $2,041.74 | Professional | None | $812.83 | $851.14 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $6,309.57 | Professional | None | $707.95 | $912.01 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $2,344.23 | Professional | None | $776.25 | $851.14 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,698.24 Typical High $1,949.84 | Professional | None | $812.83 | $1,698.24 | $1,949.84 |
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 $630.96 Median $1,202.26 Typical High $2,398.83 | Professional | None | $630.96 | $1,202.26 | $2,398.83 |
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 $398.11 Median $426.58 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $602.56 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $562.34 | $602.56 | $616.60 |
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· 39th of 51
$912
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.