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 $1,047.13 Median $3,090.30 Typical High $6,606.93 | Facility | None | $1,047.13 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,047.13 | $2,570.40 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $5,754.40 | Professional | None | $1,000.00 | $1,096.48 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,096.48 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $2,290.87 Typical High $2,344.23 | Professional | None | $954.99 | $2,290.87 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,621.81 Typical High $2,884.03 | Professional | None | $912.01 | $1,621.81 | $2,884.03 |
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 $501.19 Median $524.81 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $104.71 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $741.31 | $812.83 |
Where Washington, DC sits
The same service costs 7.9 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· 37th of 51
$1,175
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.