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 $489.78 Median $3,388.44 Typical High $6,606.93 | Facility | None | $489.78 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $2,344.23 | Professional | None | $416.87 | $512.86 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $1,318.26 | Professional | None | $371.54 | $457.09 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,122.02 | Professional | None | $489.78 | $812.83 | $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 $302.00 Median $602.56 Typical High $1,348.96 | Professional | None | $302.00 | $602.56 | $1,348.96 |
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 $199.53 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $295.12 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $58.88 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $39.81 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $275.42 | $346.74 | $346.74 |
Where Washington, DC sits
The same service costs 8.1 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
$513
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.