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 $977.24 Median $4,073.80 Typical High $8,511.38 | Facility | None | $977.24 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | None | $891.25 | $977.24 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $954.99 | Professional | None | $831.76 | $912.01 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,659.59 | Professional | None | $812.83 | $870.96 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,905.46 | Professional | None | $724.44 | $812.83 | $1,905.46 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,412.54 Typical High $6,309.57 | Facility | None | $426.58 | $1,412.54 | $6,309.57 |
United Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $2,137.96 | Professional | None | $660.69 | $812.83 | $2,137.96 |
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 $457.09 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $691.83 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $691.83 |
Where Washington, DC sits
The same service costs 5.1 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· 34th of 51
$912
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.