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 $616.60 Median $3,548.13 Typical High $4,786.30 | Facility | None | $616.60 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $1,479.11 | Professional | None | $588.84 | $616.60 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $4,073.80 | Professional | None | $524.81 | $660.69 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,698.24 | Professional | None | $562.34 | $616.60 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $1,202.26 Typical High $1,412.54 | Professional | None | $575.44 | $1,202.26 | $1,412.54 |
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 $851.14 Typical High $1,698.24 | Professional | None | $501.19 | $851.14 | $1,698.24 |
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 $288.40 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $288.40 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $114.82 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $489.78 | Professional | 54 · Surgery only | $436.52 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $97.72 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $457.09 |
Where Washington, DC sits
The same service costs 7.6 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
$661
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.