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 $512.86 Median $3,548.13 Typical High $4,786.30 | Facility | None | $512.86 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $1,288.25 | Professional | None | $478.63 | $512.86 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $2,570.40 | Professional | None | $489.78 | $549.54 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $1,445.44 | Professional | None | $457.09 | $512.86 | $1,445.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $501.19 Median $1,000.00 Typical High $1,174.90 | Professional | None | $501.19 | $1,000.00 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $371.54 Median $707.95 Typical High $1,445.44 | Professional | None | $371.54 | $707.95 | $1,445.44 |
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 $239.88 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $47.86 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $363.08 |
Where Washington, DC sits
The same service costs 7.1 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· 37th of 51
$550
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.