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 $794.33 Median $3,388.44 Typical High $6,606.93 | Facility | None | $794.33 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,995.26 | Professional | None | $741.31 | $794.33 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $5,011.87 | Professional | None | $660.69 | $851.14 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $2,187.76 | Professional | None | $707.95 | $776.25 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,548.82 Typical High $1,819.70 | Professional | None | $758.58 | $1,548.82 | $1,819.70 |
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 $575.44 Median $1,000.00 Typical High $2,187.76 | Professional | None | $575.44 | $1,000.00 | $2,187.76 |
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 $363.08 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $147.91 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $602.56 | Professional | 54 · Surgery only | $549.54 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $120.23 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $562.34 |
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· 36th of 51
$851
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.