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 $524.81 Median $4,073.80 Typical High $7,413.10 | Facility | None | $524.81 | $4,073.80 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $5,248.07 Typical High $10,715.19 | Professional | None | $512.86 | $5,248.07 | $10,715.19 |
CareFirst Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $11,220.18 | Professional | None | $489.78 | $549.54 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $1,412.54 Typical High $15,848.93 | Professional | None | $489.78 | $1,412.54 | $15,848.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $6,760.83 Typical High $14,791.08 | Professional | None | $1,174.90 | $6,760.83 | $14,791.08 |
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 $478.63 Median $1,445.44 Typical High $15,135.61 | Professional | None | $478.63 | $1,445.44 | $15,135.61 |
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 $263.03 Median $2,570.40 Typical High $3,162.28 | Professional | 52 · Reduced service | $263.03 | $2,570.40 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $1,047.13 Typical High $1,288.25 | Professional | 53 · Discontinued | $104.71 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $3,890.45 Typical High $4,786.30 | Professional | 54 · Surgery only | $389.05 | $3,890.45 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $776.25 Typical High $954.99 | Professional | 55 · Aftercare only | $77.62 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $524.81 Typical High $645.65 | Professional | 56 · Pre-op care only | $52.48 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $3,630.78 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $363.08 | $3,630.78 | $4,466.84 |
Where Washington, DC sits
The same service costs 13.5 times more in Iowa than in Kentucky. 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· 38th of 51
$1,413
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.