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 $1,905.46 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,905.46 | $1,995.26 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $6,309.57 | Professional | None | $1,995.26 | $2,238.72 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,905.46 | $2,041.74 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $3,981.07 Typical High $4,570.88 | Professional | None | $1,737.80 | $3,981.07 | $4,570.88 |
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 $1,659.59 Median $2,818.38 Typical High $5,495.41 | Professional | None | $1,659.59 | $2,818.38 | $5,495.41 |
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 $954.99 Median $1,000.00 Typical High $1,047.13 | Professional | 52 · Reduced service | $954.99 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $398.11 Typical High $426.58 | Professional | 53 · Discontinued | $380.19 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,513.56 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,445.44 | $1,513.56 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $302.00 Typical High $316.23 | Professional | 55 · Aftercare only | $288.40 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $199.53 Typical High $208.93 | Professional | 56 · Pre-op care only | $190.55 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,412.54 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,412.54 | $1,479.11 |
Where Washington, DC sits
The same service costs 21.9 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
$2,239
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.