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 $588.84 Median $3,388.44 Typical High $6,606.93 | Facility | None | $588.84 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $588.84 Typical High $1,479.11 | Professional | None | $562.34 | $588.84 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $2,630.27 | Professional | None | $467.74 | $630.96 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,621.81 | Professional | None | $537.03 | $588.84 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $1,148.15 Typical High $1,348.96 | Professional | None | $562.34 | $1,148.15 | $1,348.96 |
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 $478.63 Median $812.83 Typical High $1,659.59 | Professional | None | $478.63 | $812.83 | $1,659.59 |
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 $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $436.52 |
Where Washington, DC sits
The same service costs 7.2 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
$631
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.