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 $346.74 Median $1,698.24 Typical High $4,073.80 | Facility | None | $346.74 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $398.11 | Professional | None | $309.03 | $346.74 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $741.31 | Professional | None | $263.03 | $371.54 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $1,047.13 | Professional | None | $288.40 | $371.54 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $891.25 | Professional | None | $446.68 | $794.33 | $891.25 |
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 $251.19 Median $457.09 Typical High $954.99 | Professional | None | $251.19 | $457.09 | $954.99 |
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 $162.18 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $162.18 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $64.57 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | 54 · Surgery only | $239.88 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $269.15 |
Where Washington, DC sits
The same service costs 5.1 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
$372
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.