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 $758.58 Median $3,981.07 Typical High $7,413.10 | Facility | None | $758.58 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | None | $707.95 | $758.58 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $776.25 | Professional | None | $616.60 | $676.08 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $1,230.27 | Professional | None | $645.65 | $691.83 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,479.11 | Professional | None | $588.84 | $660.69 | $1,479.11 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $537.03 Median $616.60 Typical High $1,659.59 | Professional | None | $537.03 | $616.60 | $1,659.59 |
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 $346.74 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $346.74 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $524.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $537.03 |
Where Washington, DC sits
The same service costs 5.8 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· 42nd of 51
$676
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.