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 $3,311.31 Typical High $7,413.10 | Facility | None | $812.83 | $3,311.31 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $812.83 | Professional | None | $724.44 | $812.83 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $891.25 | Professional | None | $645.65 | $724.44 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,318.26 | Professional | None | $676.08 | $724.44 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $1,412.54 | Professional | None | $575.44 | $645.65 | $1,412.54 |
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 $562.34 Median $645.65 Typical High $1,778.28 | Professional | None | $562.34 | $645.65 | $1,778.28 |
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 $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $575.44 | $575.44 |
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· 38th of 51
$724
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.