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 $371.54 Median $1,698.24 Typical High $4,073.80 | Facility | None | $371.54 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $1,023.29 | Professional | None | $331.13 | $407.38 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $741.31 | Professional | None | $354.81 | $398.11 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $1,122.02 | Professional | None | $309.03 | $398.11 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $933.25 | Professional | None | $512.86 | $851.14 | $933.25 |
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 $275.42 Median $489.78 Typical High $1,023.29 | Professional | None | $275.42 | $489.78 | $1,023.29 |
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 $173.78 Median $186.21 Typical High $204.17 | Professional | 52 · Reduced service | $173.78 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $69.18 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $257.04 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $34.67 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $239.88 | $257.04 | $288.40 |
Where Washington, DC sits
The same service costs 4.9 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· 36th of 51
$407
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.