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 $794.33 Median $3,548.13 Typical High $4,786.30 | Facility | None | $794.33 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | None | $724.44 | $794.33 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $812.83 | Professional | None | $630.96 | $707.95 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,288.25 | Professional | None | $645.65 | $707.95 | $1,288.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,548.82 | Professional | None | $602.56 | $676.08 | $1,548.82 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,698.24 | Professional | None | $512.86 | $645.65 | $1,698.24 |
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 $363.08 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $363.08 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $144.54 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $549.54 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $562.34 |
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· 41st of 51
$708
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.