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 $537.03 Median $2,818.38 Typical High $4,786.30 | Facility | None | $537.03 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $588.84 | Professional | None | $501.19 | $537.03 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,584.89 | Professional | None | $501.19 | $575.44 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,621.81 | Professional | None | $467.74 | $575.44 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,230.27 Typical High $1,380.38 | Professional | None | $676.08 | $1,230.27 | $1,380.38 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $1,479.11 | Professional | None | $416.87 | $741.31 | $1,479.11 |
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 $251.19 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $102.33 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $416.87 |
Where Washington, DC sits
The same service costs 5.2 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
$575
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.