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 $1,862.09 Typical High $4,073.80 | Facility | None | $436.52 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | None | $380.19 | $436.52 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $5,011.87 | Professional | None | $346.74 | $467.74 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $1,230.27 | Professional | None | $371.54 | $436.52 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $1,000.00 | Professional | None | $426.58 | $831.76 | $1,000.00 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $302.00 Median $562.34 Typical High $1,230.27 | Professional | None | $302.00 | $562.34 | $1,230.27 |
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 $190.55 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $190.55 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $75.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $288.40 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $57.54 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $38.02 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $309.03 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $269.15 | $309.03 | $309.03 |
Where Washington, DC sits
The same service costs 8.1 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· 34th of 51
$468
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.