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 $549.54 Median $3,090.30 Typical High $6,606.93 | Facility | None | $549.54 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $758.58 | Professional | None | $549.54 | $630.96 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $1,584.89 | Professional | None | $537.03 | $588.84 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $2,041.74 | Professional | None | $489.78 | $724.44 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,288.25 Typical High $1,737.80 | Professional | None | $812.83 | $1,288.25 | $1,737.80 |
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 $467.74 Median $870.96 Typical High $1,905.46 | Professional | None | $467.74 | $870.96 | $1,905.46 |
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 $275.42 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $275.42 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $109.65 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $489.78 Typical High $562.34 | Professional | 54 · Surgery only | $416.87 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $97.72 Typical High $112.20 | Professional | 55 · Aftercare only | $83.18 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $457.09 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $389.05 | $457.09 | $524.81 |
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· 34th of 51
$724
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.