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 $562.34 Median $1,862.09 Typical High $4,073.80 | Facility | None | $562.34 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $562.34 | Professional | None | $436.52 | $489.78 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $831.76 | Professional | None | $416.87 | $489.78 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $954.99 | Professional | None | $416.87 | $467.74 | $954.99 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $1,202.26 | Professional | None | $316.23 | $436.52 | $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 $245.47 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $346.74 | $389.05 | $389.05 |
Where Washington, DC sits
The same service costs 6.2 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· 36th of 51
$490
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.