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 $645.65 Median $3,548.13 Typical High $4,786.30 | Facility | None | $645.65 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $676.08 | Professional | None | $562.34 | $645.65 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $4,073.80 | Professional | None | $588.84 | $660.69 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $1,698.24 | Professional | None | $549.54 | $588.84 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,258.93 Typical High $1,479.11 | Professional | None | $691.83 | $1,258.93 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $457.09 Median $812.83 Typical High $1,778.28 | Professional | None | $457.09 | $812.83 | $1,778.28 |
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 $281.84 Median $323.59 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $128.82 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $97.72 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $64.57 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $457.09 | $478.63 |
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· 38th of 51
$661
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.