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 $426.58 Median $4,168.69 Typical High $10,232.93 | Facility | None | $426.58 | $4,168.69 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $645.65 | Professional | None | $426.58 | $575.44 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $2,951.21 | Professional | None | $407.38 | $446.68 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,698.24 | Professional | None | $380.19 | $588.84 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,412.54 | Professional | None | $691.83 | $954.99 | $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 $363.08 Median $691.83 Typical High $1,548.82 | Professional | None | $363.08 | $691.83 | $1,548.82 |
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 $204.17 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $204.17 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $81.28 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $95.50 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $40.74 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $371.54 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $288.40 | $371.54 | $446.68 |
Where Washington, DC sits
The same service costs 4.9 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· 33rd of 51
$589
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.