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 $3,388.44 Typical High $6,606.93 | Facility | None | $794.33 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,819.70 | Professional | None | $741.31 | $794.33 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $6,309.57 | Professional | None | $741.31 | $812.83 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $2,089.30 | Professional | None | $707.95 | $758.58 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,548.82 Typical High $1,778.28 | Professional | None | $707.95 | $1,548.82 | $1,778.28 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $2,137.96 | Professional | None | $588.84 | $1,122.02 | $2,137.96 |
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 $354.81 Median $398.11 Typical High $407.38 | Professional | 52 · Reduced service | $354.81 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $575.44 |
Where Washington, DC sits
The same service costs 7.6 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
$813
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.