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 $912.01 Median $3,548.13 Typical High $4,786.30 | Facility | None | $912.01 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $954.99 | Professional | None | $812.83 | $912.01 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $3,235.94 | Professional | None | $851.14 | $933.25 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,659.59 Typical High $2,041.74 | Professional | None | $870.96 | $1,659.59 | $2,041.74 |
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 $630.96 Median $1,202.26 Typical High $2,454.71 | Professional | None | $630.96 | $1,202.26 | $2,454.71 |
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 $407.38 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $630.96 |
Where Washington, DC sits
The same service costs 8.9 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· 38th of 51
$933
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.