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 $3,388.44 Typical High $6,606.93 | Facility | None | $660.69 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $1,621.81 | Professional | None | $630.96 | $660.69 | $1,621.81 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $3,235.94 | Professional | None | $602.56 | $676.08 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $1,737.80 | Professional | None | $602.56 | $616.60 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $1,318.26 Typical High $1,513.56 | Professional | None | $602.56 | $1,318.26 | $1,513.56 |
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 $616.60 Median $870.96 Typical High $1,778.28 | Professional | None | $616.60 | $870.96 | $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 $316.23 Median $331.13 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $331.13 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $489.78 Typical High $645.65 | Professional | 54 · Surgery only | $478.63 | $489.78 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $97.72 Typical High $128.82 | Professional | 55 · Aftercare only | $95.50 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $457.09 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $446.68 | $457.09 | $602.56 |
Where Washington, DC sits
The same service costs 6.3 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· 43rd of 51
$724
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.