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 $933.25 Median $1,698.24 Typical High $7,943.28 | Facility | None | $933.25 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $1,047.13 | Professional | None | $891.25 | $933.25 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,096.48 | Professional | None | $912.01 | $1,000.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $2,454.71 | Professional | None | $812.83 | $851.14 | $2,454.71 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $2,137.96 | Professional | None | $912.01 | $1,905.46 | $2,137.96 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,412.54 Typical High $6,309.57 | Facility | None | $426.58 | $1,412.54 | $6,309.57 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $2,570.40 | Professional | None | $707.95 | $1,230.27 | $2,570.40 |
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 $446.68 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $446.68 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $794.33 | Professional | 54 · Surgery only | $676.08 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $158.49 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $741.31 |
Where Washington, DC sits
The same service costs 24.0 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· 37th of 51
$1,000
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.