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 $870.96 Median $3,981.07 Typical High $7,413.10 | Facility | None | $870.96 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $2,187.76 | Professional | None | $831.76 | $870.96 | $2,187.76 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $7,943.28 | Professional | None | $851.14 | $933.25 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $2,398.83 | Professional | None | $794.33 | $870.96 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,737.80 Typical High $1,995.26 | Professional | None | $831.76 | $1,737.80 | $1,995.26 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,454.71 | Professional | None | $645.65 | $1,202.26 | $2,454.71 |
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 $407.38 Median $436.52 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $630.96 |
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· 39th of 51
$933
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.