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 $3,090.30 Typical High $6,606.93 | Facility | None | $707.95 | $3,090.30 | $6,606.93 |
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 $758.58 Typical High $7,943.28 | Professional | None | $676.08 | $758.58 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $1,949.84 | Professional | None | $630.96 | $691.83 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,380.38 Typical High $1,621.81 | Professional | None | $676.08 | $1,380.38 | $1,621.81 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $512.86 Median $977.24 Typical High $1,949.84 | Professional | None | $512.86 | $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 $363.08 | Professional | 52 · Reduced service | $331.13 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $109.65 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $501.19 |
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· 37th 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.