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 $3,388.44 Typical High $6,606.93 | Facility | None | $630.96 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $676.08 | Professional | None | $588.84 | $630.96 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $4,073.80 | Professional | None | $616.60 | $676.08 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $1,737.80 | Professional | None | $575.44 | $630.96 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,445.44 | Professional | None | $616.60 | $1,230.27 | $1,445.44 |
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 $501.19 Median $870.96 Typical High $1,778.28 | Professional | None | $501.19 | $870.96 | $1,778.28 |
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 $295.12 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $446.68 | $467.74 |
Where Washington, DC sits
The same service costs 7.4 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· 41st 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.