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 $812.83 Median $4,073.80 Typical High $7,079.46 | Facility | None | $812.83 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $831.76 | Professional | None | $758.58 | $812.83 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $5,128.61 | Professional | None | $776.25 | $870.96 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $2,238.72 | Professional | None | $741.31 | $812.83 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $1,621.81 Typical High $1,862.09 | Professional | None | $776.25 | $1,621.81 | $1,862.09 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $2,238.72 | Professional | None | $616.60 | $1,148.15 | $2,238.72 |
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 $380.19 Median $407.38 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $630.96 | Professional | 54 · Surgery only | $575.44 | $616.60 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $588.84 |
Where Washington, DC sits
The same service costs 7.8 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· 37th of 51
$871
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.