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 $524.81 Median $2,818.38 Typical High $4,786.30 | Facility | None | $524.81 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $537.03 | Professional | None | $501.19 | $524.81 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $1,584.89 | Professional | None | $501.19 | $562.34 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,479.11 | Professional | None | $467.74 | $524.81 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $1,174.90 Typical High $1,230.27 | Professional | None | $588.84 | $1,174.90 | $1,230.27 |
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 $389.05 Median $707.95 Typical High $1,479.11 | Professional | None | $389.05 | $707.95 | $1,479.11 |
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 $251.19 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $251.19 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $107.15 | Professional | 53 · Discontinued | $100.00 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $371.54 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $380.19 |
Where Washington, DC sits
The same service costs 5.9 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· 36th of 51
$550
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.