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 $812.83 Median $3,388.44 Typical High $6,606.93 | Facility | None | $812.83 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $812.83 | Professional | None | $630.96 | $812.83 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $2,344.23 | Professional | None | $616.60 | $831.76 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $741.31 Typical High $2,137.96 | Professional | None | $549.54 | $741.31 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,819.70 | Professional | None | $776.25 | $1,202.26 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $467.74 Median $933.25 Typical High $2,187.76 | Professional | None | $467.74 | $933.25 | $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 $316.23 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $316.23 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $125.89 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $63.10 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $562.34 |
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· 31st of 51
$832
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.