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 $3,388.44 Typical High $6,606.93 | Facility | None | $416.87 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | None | $371.54 | $416.87 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $630.96 | Professional | None | $398.11 | $446.68 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $1,148.15 | Professional | None | $371.54 | $416.87 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $812.83 Typical High $954.99 | Professional | None | $416.87 | $812.83 | $954.99 |
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 $295.12 Median $524.81 Typical High $1,148.15 | Professional | None | $295.12 | $524.81 | $1,148.15 |
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 $186.21 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $186.21 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $37.15 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $288.40 |
Where Washington, DC sits
The same service costs 7.2 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· 36th of 51
$447
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.