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 $630.96 Median $3,548.13 Typical High $4,786.30 | Facility | None | $630.96 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | None | $501.19 | $630.96 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,584.89 | Professional | None | $512.86 | $676.08 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,737.80 | Professional | None | $512.86 | $602.56 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $1,445.44 | Professional | None | $602.56 | $1,148.15 | $1,445.44 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $1,737.80 | Professional | None | $426.58 | $794.33 | $1,737.80 |
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 $275.42 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $436.52 |
Where Washington, DC sits
The same service costs 7.1 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· 32nd of 51
$676
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.