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 $537.03 Median $4,073.80 Typical High $7,079.46 | Facility | None | $537.03 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $1,348.96 | Professional | None | $512.86 | $537.03 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $3,235.94 | Professional | None | $562.34 | $616.60 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,479.11 | Professional | None | $524.81 | $537.03 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $1,071.52 Typical High $1,230.27 | Professional | None | $512.86 | $1,071.52 | $1,230.27 |
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 $446.68 Median $776.25 Typical High $1,513.56 | Professional | None | $446.68 | $776.25 | $1,513.56 |
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 $257.04 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $257.04 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $51.29 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $380.19 | $416.87 |
Where Washington, DC sits
The same service costs 7.1 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· 35th of 51
$617
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.