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 $891.25 Median $4,073.80 Typical High $7,079.46 | Facility | None | $891.25 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $2,137.96 | Professional | None | $831.76 | $891.25 | $2,137.96 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $2,951.21 | Professional | None | $851.14 | $933.25 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $2,454.71 | Professional | None | $776.25 | $870.96 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,698.24 Typical High $1,995.26 | Professional | None | $831.76 | $1,698.24 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $2,454.71 | Professional | None | $645.65 | $1,122.02 | $2,454.71 |
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 $407.38 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $630.96 |
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· 37th of 51
$933
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.