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 $1,698.24 Typical High $7,943.28 | Facility | None | $794.33 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $1,995.26 | Professional | None | $776.25 | $794.33 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $18,197.01 | Professional | None | $812.83 | $912.01 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $776.25 Typical High $2,187.76 | Professional | None | $758.58 | $776.25 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,621.81 Typical High $1,819.70 | Professional | None | $741.31 | $1,621.81 | $1,819.70 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $2,187.76 | Professional | None | $645.65 | $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 $426.58 | Professional | 52 · Reduced service | $363.08 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $645.65 | Professional | 54 · Surgery only | $549.54 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $602.56 |
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· 36th of 51
$912
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.