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 $602.56 Median $2,691.53 Typical High $7,413.10 | Facility | None | $602.56 | $2,691.53 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,819.70 | Professional | None | $602.56 | $1,000.00 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $5,011.87 | Professional | None | $616.60 | $691.83 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,000.00 Typical High $2,884.03 | Professional | None | $588.84 | $1,000.00 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,412.54 | $2,454.71 |
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 $549.54 Median $1,096.48 Typical High $2,630.27 | Professional | None | $549.54 | $1,096.48 | $2,630.27 |
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 $302.00 Median $446.68 Typical High $537.03 | Professional | 52 · Reduced service | $302.00 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $123.03 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $676.08 Typical High $794.33 | Professional | 54 · Surgery only | $457.09 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $91.20 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $91.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $60.26 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $630.96 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $426.58 | $630.96 | $741.31 |
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· 27th of 51
$1,000
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.