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 $338.84 Median $1,698.24 Typical High $5,248.07 | Facility | None | $338.84 | $1,698.24 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $891.25 | Professional | None | $338.84 | $524.81 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $4,073.80 | Professional | None | $323.59 | $363.08 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $1,412.54 | Professional | None | $295.12 | $489.78 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,174.90 | Professional | None | $549.54 | $776.25 | $1,174.90 |
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 $288.40 Median $575.44 Typical High $1,288.25 | Professional | None | $288.40 | $575.44 | $1,288.25 |
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 $169.82 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $169.82 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $67.61 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $257.04 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $51.29 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.88 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $239.88 | $309.03 | $363.08 |
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
$490
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.