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 $1,698.24 Typical High $4,073.80 | Facility | None | $524.81 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $562.34 | Professional | None | $489.78 | $524.81 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $562.34 Typical High $741.31 | Professional | None | $489.78 | $562.34 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $1,513.56 | Professional | None | $446.68 | $537.03 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $1,288.25 | Professional | None | $616.60 | $1,202.26 | $1,288.25 |
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 $380.19 Median $691.83 Typical High $1,445.44 | Professional | None | $380.19 | $691.83 | $1,445.44 |
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 $245.47 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $112.20 | Professional | 53 · Discontinued | $97.72 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $363.08 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $52.48 Typical High $56.23 | Professional | 56 · Pre-op care only | $48.98 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $389.05 |
Where Washington, DC sits
The same service costs 5.8 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· 34th of 51
$562
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.