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 $407.38 Median $3,090.30 Typical High $6,606.93 | Facility | None | $407.38 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $1,348.96 | Professional | None | $407.38 | $645.65 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $2,818.38 | Professional | None | $302.00 | $363.08 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $870.96 Typical High $1,318.26 | Professional | None | $338.84 | $870.96 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,584.89 | Professional | None | $758.58 | $1,122.02 | $1,584.89 |
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 $389.05 Median $912.01 Typical High $1,584.89 | Professional | None | $389.05 | $912.01 | $1,584.89 |
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 $204.17 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $204.17 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $81.28 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $288.40 | $389.05 | $446.68 |
Where Washington, DC sits
The same service costs 4.3 times more in Wisconsin 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· 24th of 51
$759
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.