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 $389.05 Median $1,862.09 Typical High $4,073.80 | Facility | None | $389.05 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $389.05 | Professional | None | $316.23 | $389.05 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $2,089.30 | Professional | None | $309.03 | $416.87 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $1,096.48 | Professional | None | $316.23 | $380.19 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $891.25 | Professional | None | $398.11 | $707.95 | $891.25 |
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 $251.19 Median $467.74 Typical High $1,071.52 | Professional | None | $251.19 | $467.74 | $1,071.52 |
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 $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $158.49 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $63.10 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $239.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $31.62 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $223.87 | $269.15 | $269.15 |
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· 31st 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.