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 $741.31 Median $812.83 Typical High $851.14 | Professional | None | $741.31 | $812.83 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $977.24 | Professional | None | $630.96 | $851.14 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $2,238.72 | Professional | None | $741.31 | $794.33 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,584.89 Typical High $1,819.70 | Professional | None | $758.58 | $1,584.89 | $1,819.70 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $2,238.72 | Professional | None | $645.65 | $1,122.02 | $2,238.72 |
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 $371.54 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $562.34 | $602.56 |
Where Washington, DC sits
The same service costs 8.3 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
$851
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.