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 $776.25 Median $3,981.07 Typical High $7,413.10 | Facility | None | $776.25 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,949.84 | Professional | None | $676.08 | $776.25 | $1,949.84 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $3,715.35 | Professional | None | $724.44 | $812.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $2,089.30 | Professional | None | $645.65 | $724.44 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,380.38 Typical High $1,737.80 | Professional | None | $758.58 | $1,380.38 | $1,737.80 |
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 $524.81 Median $1,023.29 Typical High $2,137.96 | Professional | None | $524.81 | $1,023.29 | $2,137.96 |
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 $346.74 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $549.54 |
Where Washington, DC sits
The same service costs 7.2 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· 35th of 51
$813
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.