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 $724.44 Median $3,548.13 Typical High $4,786.30 | Facility | None | $724.44 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $776.25 | Professional | None | $616.60 | $724.44 | $776.25 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $3,235.94 | Professional | None | $676.08 | $741.31 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $1,949.84 | Professional | None | $588.84 | $676.08 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $1,621.81 | Professional | None | $691.83 | $1,258.93 | $1,621.81 |
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 $467.74 Median $933.25 Typical High $1,949.84 | Professional | None | $467.74 | $933.25 | $1,949.84 |
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 $309.03 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $501.19 |
Where Washington, DC sits
The same service costs 6.9 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
$741
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.