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 $346.74 Median $1,862.09 Typical High $4,073.80 | Facility | None | $346.74 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $870.96 | Professional | None | $316.23 | $346.74 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $2,089.30 | Professional | None | $302.00 | $371.54 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $977.24 | Professional | None | $302.00 | $346.74 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $660.69 Typical High $794.33 | Professional | None | $338.84 | $660.69 | $794.33 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $977.24 | Professional | None | $245.47 | $457.09 | $977.24 |
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 $158.49 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $158.49 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $63.10 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $47.86 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $31.62 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $223.87 | $245.47 | $245.47 |
Where Washington, DC sits
The same service costs 7.9 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· 38th of 51
$372
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.