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 $416.87 Median $1,698.24 Typical High $4,073.80 | Facility | None | $416.87 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | None | $380.19 | $416.87 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $1,380.38 | Professional | None | $380.19 | $446.68 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $1,258.93 | Professional | None | $363.08 | $446.68 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $1,047.13 | Professional | None | $537.03 | $954.99 | $1,047.13 |
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 $323.59 Median $562.34 Typical High $1,148.15 | Professional | None | $323.59 | $562.34 | $1,148.15 |
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 $194.98 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $194.98 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $77.62 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $295.12 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $288.40 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $275.42 | $288.40 | $323.59 |
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· 37th of 51
$447
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.