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 $1,412.54 Median $4,073.80 Typical High $7,943.28 | Facility | None | $1,412.54 | $4,073.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $4,265.80 | Professional | None | $3,715.35 | $4,073.80 | $4,265.80 |
CareFirst Setting Professional Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $18,197.01 | Professional | None | $4,168.69 | $4,570.88 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $10,964.78 | Professional | None | $3,715.35 | $3,981.07 | $10,964.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $8,128.31 Typical High $9,120.11 | Professional | None | $3,630.78 | $8,128.31 | $9,120.11 |
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 $3,235.94 Median $5,888.44 Typical High $11,220.18 | Professional | None | $3,235.94 | $5,888.44 | $11,220.18 |
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 $1,862.09 Median $2,041.74 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,862.09 | $2,041.74 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $812.83 Typical High $851.14 | Professional | 53 · Discontinued | $741.31 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,019.95 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,818.38 | $3,019.95 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $602.56 Typical High $645.65 | Professional | 55 · Aftercare only | $562.34 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $407.38 Typical High $426.58 | Professional | 56 · Pre-op care only | $371.54 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,818.38 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,818.38 | $3,019.95 |
Where Washington, DC sits
The same service costs 20.4 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· 36th of 51
$4,571
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.