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 $354.81 Median $1,698.24 Typical High $4,073.80 | Facility | None | $354.81 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $478.63 | Professional | None | $354.81 | $398.11 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $363.08 | Professional | None | $288.40 | $316.23 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $645.65 | Professional | None | $302.00 | $407.38 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $870.96 | Professional | None | $398.11 | $446.68 | $870.96 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $812.83 | Professional | None | $269.15 | $380.19 | $812.83 |
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 $173.78 Median $194.98 Typical High $239.88 | Professional | 52 · Reduced service | $173.78 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $95.50 | Professional | 53 · Discontinued | $70.79 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $263.03 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $47.86 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $275.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $245.47 | $275.42 | $338.84 |
Where Washington, DC sits
The same service costs 4.0 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
$355
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.