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 $3,981.07 Typical High $7,413.10 | Facility | None | $1,698.24 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,344.23 | $2,511.89 | $2,511.89 |
CareFirst Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $8,912.51 | Professional | None | $2,454.71 | $2,818.38 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $6,918.31 | Professional | None | $2,187.76 | $2,454.71 | $6,918.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,398.83 Median $5,128.61 Typical High $5,754.40 | Professional | None | $2,398.83 | $5,128.61 | $5,754.40 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $3,311.31 Typical High $7,079.46 | Professional | None | $1,819.70 | $3,311.31 | $7,079.46 |
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 $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,122.02 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $457.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,698.24 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $1,862.09 |
Where Washington, DC sits
The same service costs 15.8 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
$2,754
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.