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 $870.96 Median $3,548.13 Typical High $4,786.30 | Facility | None | $870.96 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $870.96 | Professional | None | $741.31 | $870.96 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $2,089.30 | Professional | None | $724.44 | $891.25 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $2,398.83 | Professional | None | $707.95 | $831.76 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,548.82 Typical High $1,995.26 | Professional | None | $851.14 | $1,548.82 | $1,995.26 |
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 $575.44 Median $1,071.52 Typical High $2,398.83 | Professional | None | $575.44 | $1,071.52 | $2,398.83 |
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 $371.54 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $371.54 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $147.91 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $562.34 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $616.60 |
Where Washington, DC sits
The same service costs 8.3 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
$891
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.