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 $660.69 Median $4,073.80 Typical High $10,232.93 | Facility | None | $660.69 | $4,073.80 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $660.69 | Professional | None | $602.56 | $660.69 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $707.95 | Professional | None | $537.03 | $588.84 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,071.52 | Professional | None | $537.03 | $602.56 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $1,148.15 | Professional | None | $512.86 | $575.44 | $1,148.15 |
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 $426.58 Median $537.03 Typical High $1,445.44 | Professional | None | $426.58 | $537.03 | $1,445.44 |
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 $302.00 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $467.74 |
Where Washington, DC sits
The same service costs 5.5 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· 39th of 51
$603
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.