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 $2,187.76 Typical High $5,248.07 | Facility | None | $524.81 | $2,187.76 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,288.25 | Professional | None | $512.86 | $812.83 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $5,011.87 | Professional | None | $524.81 | $588.84 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $831.76 Typical High $2,398.83 | Professional | None | $467.74 | $831.76 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,995.26 | Professional | None | $933.25 | $1,202.26 | $1,995.26 |
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 $467.74 Median $912.01 Typical High $2,187.76 | Professional | None | $467.74 | $912.01 | $2,187.76 |
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 $354.81 Typical High $436.52 | Professional | 52 · Reduced service | $263.03 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $144.54 Typical High $177.83 | Professional | 53 · Discontinued | $104.71 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $537.03 Typical High $660.69 | Professional | 54 · Surgery only | $389.05 | $537.03 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $107.15 Typical High $131.83 | Professional | 55 · Aftercare only | $77.62 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $72.44 Typical High $89.13 | Professional | 56 · Pre-op care only | $52.48 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $501.19 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $363.08 | $501.19 | $616.60 |
Where Washington, DC sits
The same service costs 4.7 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· 28th of 51
$832
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.