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 $426.58 Median $3,548.13 Typical High $4,786.30 | Facility | None | $426.58 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $1,071.52 | Professional | None | $398.11 | $426.58 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $4,073.80 | Professional | None | $416.87 | $457.09 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $1,202.26 | Professional | None | $380.19 | $426.58 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $831.76 Typical High $977.24 | Professional | None | $416.87 | $831.76 | $977.24 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $1,202.26 | Professional | None | $309.03 | $575.44 | $1,202.26 |
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 $199.53 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $302.00 |
Where Washington, DC sits
The same service costs 6.8 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· 39th of 51
$457
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.