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 $977.24 Median $4,073.80 Typical High $7,079.46 | Facility | None | $977.24 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | None | $891.25 | $977.24 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $5,128.61 | Professional | None | $912.01 | $1,023.29 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $2,630.27 | Professional | None | $831.76 | $933.25 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,819.70 Typical High $2,238.72 | Professional | None | $977.24 | $1,819.70 | $2,238.72 |
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 $691.83 Median $1,318.26 Typical High $2,691.53 | Professional | None | $691.83 | $1,318.26 | $2,691.53 |
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 $446.68 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $691.83 |
Where Washington, DC sits
The same service costs 7.4 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
$1,023
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.