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 $954.99 Median $3,388.44 Typical High $6,606.93 | Facility | None | $954.99 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | None | $891.25 | $954.99 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $3,235.94 | Professional | None | $912.01 | $1,023.29 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $2,187.76 | Professional | None | $912.01 | $1,905.46 | $2,187.76 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $2,630.27 | Professional | None | $707.95 | $1,258.93 | $2,630.27 |
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 $446.68 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $691.83 |
Where Washington, DC sits
The same service costs 17.4 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
$1,023
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.