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 $436.52 Median $2,818.38 Typical High $4,786.30 | Facility | None | $436.52 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $630.96 | Professional | None | $416.87 | $512.86 | $630.96 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $2,570.40 | Professional | None | $416.87 | $457.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $1,698.24 | Professional | None | $389.05 | $588.84 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,412.54 | Professional | None | $660.69 | $1,000.00 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $363.08 Median $691.83 Typical High $1,548.82 | Professional | None | $363.08 | $691.83 | $1,548.82 |
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 $208.93 Median $257.04 Typical High $316.23 | Professional | 52 · Reduced service | $208.93 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $83.18 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $316.23 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $63.10 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $51.29 Typical High $63.10 | Professional | 56 · Pre-op care only | $41.69 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $363.08 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $295.12 | $363.08 | $436.52 |
Where Washington, DC sits
The same service costs 5.2 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· 33rd of 51
$589
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.