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 $812.83 Median $1,949.84 Typical High $4,073.80 | Facility | None | $812.83 | $1,949.84 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $2,041.74 | Professional | None | $724.44 | $812.83 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $3,235.94 | Professional | None | $758.58 | $831.76 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $2,187.76 | Professional | None | $691.83 | $758.58 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,445.44 Typical High $1,819.70 | Professional | None | $794.33 | $1,445.44 | $1,819.70 |
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 $549.54 Median $1,071.52 Typical High $2,238.72 | Professional | None | $549.54 | $1,071.52 | $2,238.72 |
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 $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $549.54 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $562.34 |
Where Washington, DC sits
The same service costs 7.2 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· 35th 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.