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 $389.05 Median $1,412.54 Typical High $7,943.28 | Facility | None | $389.05 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $977.24 | Professional | None | $363.08 | $436.52 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $1,584.89 | Professional | None | $302.00 | $436.52 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $1,174.90 | Professional | None | $323.59 | $416.87 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $891.25 Typical High $1,000.00 | Professional | None | $478.63 | $891.25 | $1,000.00 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $1,071.52 | Professional | None | $281.84 | $512.86 | $1,071.52 |
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 $181.97 Median $194.98 Typical High $213.80 | Professional | 52 · Reduced service | $181.97 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $302.00 |
Where Washington, DC sits
The same service costs 5.1 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· 30th of 51
$437
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.