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 $660.69 Median $3,090.30 Typical High $6,606.93 | Facility | None | $660.69 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $1,380.38 | Professional | None | $616.60 | $660.69 | $1,380.38 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $6,309.57 | Professional | None | $630.96 | $707.95 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,819.70 | Professional | None | $588.84 | $660.69 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $1,288.25 Typical High $1,513.56 | Professional | None | $630.96 | $1,288.25 | $1,513.56 |
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 $478.63 Median $912.01 Typical High $1,819.70 | Professional | None | $478.63 | $912.01 | $1,819.70 |
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 $309.03 Median $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $131.83 Typical High $134.90 | Professional | 53 · Discontinued | $123.03 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $66.07 Typical High $67.61 | Professional | 56 · Pre-op care only | $61.66 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $467.74 |
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
$708
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.