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 $741.31 Median $3,548.13 Typical High $4,786.30 | Facility | None | $741.31 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $758.58 | Professional | None | $691.83 | $741.31 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $2,089.30 | Professional | None | $467.74 | $776.25 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $2,041.74 | Professional | None | $630.96 | $724.44 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,445.44 Typical High $1,698.24 | Professional | None | $691.83 | $1,445.44 | $1,698.24 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $524.81 Median $1,000.00 Typical High $2,041.74 | Professional | None | $524.81 | $1,000.00 | $2,041.74 |
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 $371.54 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $371.54 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $151.36 | Professional | 53 · Discontinued | $138.04 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $537.03 |
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· 36th of 51
$776
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.