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 $446.68 Median $1,698.24 Typical High $4,073.80 | Facility | None | $446.68 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $1,348.96 | Professional | None | $407.38 | $501.19 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $1,380.38 | Professional | None | $389.05 | $478.63 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $1,348.96 | Professional | None | $380.19 | $478.63 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,148.15 | Professional | None | $630.96 | $1,023.29 | $1,148.15 |
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 $331.13 Median $588.84 Typical High $1,230.27 | Professional | None | $331.13 | $588.84 | $1,230.27 |
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 $208.93 Median $223.87 Typical High $245.47 | Professional | 52 · Reduced service | $208.93 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $100.00 | Professional | 53 · Discontinued | $83.18 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $309.03 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $346.74 |
Where Washington, DC sits
The same service costs 4.9 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· 33rd of 51
$501
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.