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 $398.11 Median $1,698.24 Typical High $4,786.30 | Facility | None | $398.11 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $1,174.90 | Professional | None | $389.05 | $562.34 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $4,073.80 | Professional | None | $389.05 | $436.52 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $575.44 Typical High $1,659.59 | Professional | None | $354.81 | $575.44 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,380.38 | Professional | None | $630.96 | $933.25 | $1,380.38 |
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 $338.84 Median $660.69 Typical High $1,479.11 | Professional | None | $338.84 | $660.69 | $1,479.11 |
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 $194.98 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $194.98 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $79.43 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $295.12 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $58.88 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $38.90 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $275.42 | $354.81 | $426.58 |
Where Washington, DC sits
The same service costs 4.8 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· 32nd of 51
$575
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.