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 $501.19 Median $1,698.24 Typical High $4,073.80 | Facility | None | $501.19 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $1,380.38 | Professional | None | $478.63 | $549.54 | $1,380.38 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $1,380.38 | Professional | None | $446.68 | $537.03 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $1,513.56 | Professional | None | $436.52 | $524.81 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $1,148.15 Typical High $1,258.93 | Professional | None | $660.69 | $1,148.15 | $1,258.93 |
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 $707.95 Typical High $1,380.38 | Professional | None | $380.19 | $707.95 | $1,380.38 |
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 $234.42 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $234.42 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $354.81 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $70.79 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $46.77 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $331.13 | $354.81 | $389.05 |
Where Washington, DC sits
The same service costs 5.0 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
$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.