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 $707.95 Median $4,073.80 Typical High $7,079.46 | Facility | None | $707.95 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,737.80 | Professional | None | $660.69 | $707.95 | $1,737.80 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $5,128.61 | Professional | None | $676.08 | $741.31 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $1,949.84 | Professional | None | $645.65 | $691.83 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,380.38 Typical High $1,584.89 | Professional | None | $645.65 | $1,380.38 | $1,584.89 |
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 $562.34 Median $977.24 Typical High $1,949.84 | Professional | None | $562.34 | $977.24 | $1,949.84 |
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 $331.13 Median $354.81 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $489.78 | $524.81 |
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· 39th of 51
$759
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.