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 $954.99 Median $3,981.07 Typical High $7,413.10 | Facility | None | $954.99 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $977.24 | Professional | None | $870.96 | $954.99 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $9,772.37 | Professional | None | $912.01 | $1,000.00 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $2,630.27 | Professional | None | $851.14 | $933.25 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,862.09 Typical High $2,137.96 | Professional | None | $891.25 | $1,862.09 | $2,137.96 |
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 $691.83 Median $1,318.26 Typical High $2,630.27 | Professional | None | $691.83 | $1,318.26 | $2,630.27 |
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 $436.52 Median $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $691.83 |
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
$1,000
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.