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 $2,187.76 Median $2,398.83 Typical High $2,511.89 | Professional | None | $2,187.76 | $2,398.83 | $2,511.89 |
CareFirst Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $6,309.57 | Professional | None | $2,398.83 | $2,630.27 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $6,456.54 | Professional | None | $2,187.76 | $2,290.87 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $4,677.35 Typical High $5,370.32 | Professional | None | $2,089.30 | $4,677.35 | $5,370.32 |
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 $1,778.28 Median $3,311.31 Typical High $6,456.54 | Professional | None | $1,778.28 | $3,311.31 | $6,456.54 |
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 $1,096.48 Median $1,174.90 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,096.48 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $478.63 Typical High $501.19 | Professional | 53 · Discontinued | $436.52 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,778.28 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,659.59 | $1,778.28 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $354.81 Typical High $371.54 | Professional | 55 · Aftercare only | $331.13 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $239.88 Typical High $251.19 | Professional | 56 · Pre-op care only | $218.78 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,659.59 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,659.59 | $1,737.80 |
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· 34th of 51
$2,630
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.