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 $575.44 Median $3,388.44 Typical High $6,606.93 | Facility | None | $575.44 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $1,412.54 | Professional | None | $537.03 | $575.44 | $1,412.54 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $4,073.80 | Professional | None | $549.54 | $602.56 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $1,584.89 | Professional | None | $549.54 | $562.34 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $1,174.90 Typical High $1,288.25 | Professional | None | $549.54 | $1,174.90 | $1,288.25 |
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 $851.14 Typical High $1,778.28 | Professional | None | $446.68 | $851.14 | $1,778.28 |
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 $288.40 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $114.82 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $398.11 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $371.54 | $398.11 | $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· 40th 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.