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 $416.87 Median $1,737.80 Typical High $6,456.54 | Facility | None | $416.87 | $1,737.80 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,258.93 | Professional | None | $407.38 | $616.60 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $5,128.61 | Professional | None | $407.38 | $446.68 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $602.56 Typical High $1,737.80 | Professional | None | $380.19 | $602.56 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,479.11 | Professional | None | $676.08 | $977.24 | $1,479.11 |
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 $363.08 Median $691.83 Typical High $1,584.89 | Professional | None | $363.08 | $691.83 | $1,584.89 |
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 $208.93 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $208.93 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $128.82 | Professional | 53 · Discontinued | $83.18 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $398.11 Typical High $478.63 | Professional | 54 · Surgery only | $316.23 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $371.54 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $295.12 | $371.54 | $446.68 |
Where Washington, DC sits
The same service costs 4.9 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
$603
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.