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 $363.08 Median $2,818.38 Typical High $4,786.30 | Facility | None | $363.08 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $912.01 | Professional | None | $363.08 | $512.86 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $2,570.40 | Professional | None | $354.81 | $398.11 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $524.81 Typical High $1,513.56 | Professional | None | $323.59 | $524.81 | $1,513.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,258.93 | Professional | None | $588.84 | $851.14 | $1,258.93 |
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 $323.59 Median $602.56 Typical High $1,380.38 | Professional | None | $323.59 | $602.56 | $1,380.38 |
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 $181.97 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $181.97 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $72.44 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $275.42 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $54.95 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $257.04 | $331.13 | $389.05 |
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· 33rd of 51
$525
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.