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 $870.96 Median $4,265.80 Typical High $8,511.38 | Facility | None | $870.96 | $4,265.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $2,187.76 Typical High $16,218.10 | Professional | None | $870.96 | $2,187.76 | $16,218.10 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $9,549.93 | Professional | None | $741.31 | $831.76 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $2,754.23 Typical High $20,892.96 | Professional | None | $794.33 | $2,754.23 | $20,892.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,309.57 Median $6,606.93 Typical High $13,489.63 | Professional | None | $6,309.57 | $6,606.93 | $13,489.63 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $707.95 Median $2,290.87 Typical High $17,378.01 | Professional | None | $707.95 | $2,290.87 | $17,378.01 |
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 $436.52 Median $575.44 Typical High $3,630.78 | Professional | 52 · Reduced service | $436.52 | $575.44 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $229.09 Typical High $1,445.44 | Professional | 53 · Discontinued | $173.78 | $229.09 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $870.96 Typical High $5,370.32 | Professional | 54 · Surgery only | $660.69 | $870.96 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $173.78 Typical High $1,071.52 | Professional | 55 · Aftercare only | $131.83 | $173.78 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $114.82 Typical High $724.44 | Professional | 56 · Pre-op care only | $87.10 | $114.82 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $812.83 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $616.60 | $812.83 | $5,011.87 |
Where Washington, DC sits
The same service costs 7.9 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· 44th of 51
$2,291
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.