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 $954.99 Median $3,090.30 Typical High $6,606.93 | Facility | None | $954.99 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $2,290.87 | Professional | None | $891.25 | $954.99 | $2,290.87 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $12,302.69 | Professional | None | $912.01 | $1,000.00 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $2,630.27 | Professional | None | $851.14 | $933.25 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,862.09 Typical High $2,187.76 | Professional | None | $891.25 | $1,862.09 | $2,187.76 |
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 $691.83 Median $1,258.93 Typical High $2,630.27 | Professional | None | $691.83 | $1,258.93 | $2,630.27 |
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 $446.68 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $676.08 |
Where Washington, DC sits
The same service costs 7.4 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
$1,000
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.