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 $501.19 Median $3,388.44 Typical High $6,606.93 | Facility | None | $501.19 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $562.34 | Professional | None | $457.09 | $501.19 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $2,344.23 | Professional | None | $436.52 | $524.81 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $1,348.96 | Professional | None | $389.05 | $467.74 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,122.02 | Professional | None | $501.19 | $831.76 | $1,122.02 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $309.03 Median $616.60 Typical High $1,380.38 | Professional | None | $309.03 | $616.60 | $1,380.38 |
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 $204.17 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $354.81 |
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· 34th of 51
$525
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.