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 $794.33 Median $2,818.38 Typical High $4,786.30 | Facility | None | $794.33 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,659.59 | Professional | None | $724.44 | $794.33 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $2,089.30 | Professional | None | $758.58 | $831.76 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $2,137.96 | Professional | None | $724.44 | $776.25 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,548.82 Typical High $1,778.28 | Professional | None | $794.33 | $1,548.82 | $1,778.28 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,187.76 | Professional | None | $602.56 | $1,122.02 | $2,187.76 |
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 $363.08 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $575.44 |
Where Washington, DC sits
The same service costs 7.1 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· 38th of 51
$832
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.