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 $354.81 Median $1,548.82 Typical High $3,311.31 | Facility | None | $354.81 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $954.99 | Professional | None | $295.12 | $371.54 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $724.44 | Professional | None | $363.08 | $407.38 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $1,023.29 | Professional | None | $288.40 | $363.08 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $812.83 Typical High $851.14 | Professional | None | $416.87 | $812.83 | $851.14 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $218.78 Median $436.52 Typical High $1,000.00 | Professional | None | $218.78 | $436.52 | $1,000.00 |
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 $154.88 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $154.88 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $269.15 Typical High $281.84 | Professional | 54 · Surgery only | $234.42 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $53.70 Typical High $56.23 | Professional | 55 · Aftercare only | $46.77 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $251.19 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $218.78 | $251.19 | $263.03 |
Where Washington, DC sits
The same service costs 5.6 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· 26th of 51
$407
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.