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 $524.81 Median $2,344.23 Typical High $5,248.07 | Facility | None | $524.81 | $2,344.23 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $1,621.81 | Professional | None | $524.81 | $870.96 | $1,621.81 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $4,073.80 | Professional | None | $537.03 | $588.84 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $2,511.89 | Professional | None | $489.78 | $870.96 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,137.96 | Professional | None | $954.99 | $1,202.26 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $478.63 Median $977.24 Typical High $2,290.87 | Professional | None | $478.63 | $977.24 | $2,290.87 |
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 $263.03 Median $371.54 Typical High $467.74 | Professional | 52 · Reduced service | $263.03 | $371.54 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $147.91 Typical High $186.21 | Professional | 53 · Discontinued | $104.71 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $549.54 Typical High $707.95 | Professional | 54 · Surgery only | $398.11 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $109.65 Typical High $141.25 | Professional | 55 · Aftercare only | $79.43 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $74.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $52.48 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $512.86 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $371.54 | $512.86 | $660.69 |
Where Washington, DC sits
The same service costs 4.6 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· 24th of 51
$891
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.