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 $741.31 Median $1,862.09 Typical High $4,073.80 | Facility | None | $741.31 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | None | $630.96 | $741.31 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $691.83 Typical High $851.14 | Professional | None | $478.63 | $691.83 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,949.84 | Professional | None | $588.84 | $691.83 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $1,659.59 | Professional | None | $724.44 | $1,288.25 | $1,659.59 |
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 $478.63 Median $954.99 Typical High $1,995.26 | Professional | None | $478.63 | $954.99 | $1,995.26 |
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 $316.23 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $478.63 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $446.68 | $512.86 | $512.86 |
Where Washington, DC sits
The same service costs 7.8 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
$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.