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 $616.60 Median $3,388.44 Typical High $6,606.93 | Facility | None | $616.60 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,513.56 | Professional | None | $562.34 | $616.60 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $4,073.80 | Professional | None | $562.34 | $660.69 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $1,698.24 | Professional | None | $549.54 | $602.56 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $1,174.90 Typical High $1,412.54 | Professional | None | $575.44 | $1,174.90 | $1,412.54 |
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 $436.52 Median $812.83 Typical High $1,698.24 | Professional | None | $436.52 | $812.83 | $1,698.24 |
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 $281.84 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $467.74 | Professional | 54 · Surgery only | $426.58 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $93.33 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $436.52 |
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· 35th of 51
$661
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.