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 $1,698.24 Median $4,073.80 Typical High $7,079.46 | Facility | None | $1,698.24 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,691.53 | $2,951.21 | $3,090.30 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $3,235.94 Typical High $3,715.35 | Professional | None | $630.96 | $3,235.94 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $8,128.31 | Professional | None | $2,630.27 | $2,884.03 | $8,128.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $5,888.44 Typical High $6,606.93 | Professional | None | $2,630.27 | $5,888.44 | $6,606.93 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $4,073.80 Typical High $8,128.31 | Professional | None | $2,187.76 | $4,073.80 | $8,128.31 |
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 $1,348.96 Median $1,479.11 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $588.84 Typical High $616.60 | Professional | 53 · Discontinued | $537.03 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,187.76 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,041.74 | $2,187.76 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $436.52 Typical High $467.74 | Professional | 55 · Aftercare only | $407.38 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $295.12 Typical High $309.03 | Professional | 56 · Pre-op care only | $269.15 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,041.74 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,041.74 | $2,187.76 |
Where Washington, DC sits
The same service costs 19.1 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· 35th of 51
$3,236
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.