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 $776.25 Median $3,388.44 Typical High $6,606.93 | Facility | None | $776.25 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $794.33 | Professional | None | $724.44 | $776.25 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $4,073.80 | Professional | None | $741.31 | $831.76 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $2,137.96 | Professional | None | $691.83 | $758.58 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,513.56 Typical High $1,778.28 | Professional | None | $724.44 | $1,513.56 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $2,137.96 | Professional | None | $562.34 | $1,071.52 | $2,137.96 |
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 $363.08 Median $389.05 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $537.03 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $79.43 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $562.34 |
Where Washington, DC sits
The same service costs 7.6 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· 39th of 51
$832
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.