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 $933.25 Median $4,073.80 Typical High $7,079.46 | Facility | None | $933.25 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | None | $851.14 | $933.25 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $6,309.57 | Professional | None | $891.25 | $977.24 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $2,511.89 | Professional | None | $794.33 | $891.25 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $2,137.96 | Professional | None | $912.01 | $1,698.24 | $2,137.96 |
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 $1,258.93 Typical High $2,570.40 | Professional | None | $645.65 | $1,258.93 | $2,570.40 |
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 $426.58 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $660.69 | $660.69 |
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· 36th of 51
$977
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.