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 $3,548.13 Typical High $4,786.30 | Facility | None | $602.56 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | None | $537.03 | $602.56 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $6,309.57 | Professional | None | $512.86 | $676.08 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,737.80 | Professional | None | $501.19 | $602.56 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $1,445.44 | Professional | None | $588.84 | $1,096.48 | $1,445.44 |
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 $407.38 Median $794.33 Typical High $1,737.80 | Professional | None | $407.38 | $794.33 | $1,737.80 |
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 $269.15 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $269.15 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $380.19 | $416.87 | $416.87 |
Where Washington, DC sits
The same service costs 7.6 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· 34th of 51
$676
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.