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 $1,584.89 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,584.89 | $1,698.24 | $1,778.28 |
CareFirst Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $4,570.88 | Professional | None | $1,584.89 | $1,778.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $4,570.88 | Professional | None | $1,548.82 | $1,659.59 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $3,388.44 Typical High $3,801.89 | Professional | None | $1,479.11 | $3,388.44 | $3,801.89 |
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 $1,288.25 Median $2,398.83 Typical High $4,677.35 | Professional | None | $1,288.25 | $2,398.83 | $4,677.35 |
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 $794.33 Median $851.14 Typical High $891.25 | Professional | 52 · Reduced service | $794.33 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $354.81 | Professional | 53 · Discontinued | $316.23 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,288.25 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,288.25 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,202.26 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,202.26 | $1,258.93 |
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· 37th of 51
$1,778
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.