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 $478.63 Median $2,818.38 Typical High $4,786.30 | Facility | None | $478.63 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $478.63 Typical High $676.08 | Professional | None | $467.74 | $478.63 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $2,570.40 | Professional | None | $389.05 | $426.58 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $1,122.02 | Professional | None | $416.87 | $562.34 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $1,318.26 | Professional | None | $602.56 | $691.83 | $1,318.26 |
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 $380.19 Median $537.03 Typical High $1,202.26 | Professional | None | $380.19 | $537.03 | $1,202.26 |
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 $234.42 Median $239.88 Typical High $338.84 | Professional | 52 · Reduced service | $234.42 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $95.50 Typical High $134.90 | Professional | 53 · Discontinued | $93.33 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $354.81 | $363.08 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $47.86 Typical High $67.61 | Professional | 56 · Pre-op care only | $46.77 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $338.84 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $331.13 | $338.84 | $478.63 |
Where Washington, DC sits
The same service costs 5.0 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· 46th of 51
$525
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.