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 $8,511.38 | Facility | None | $1,698.24 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,737.80 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $15,848.93 | Professional | None | $1,862.09 | $2,089.30 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $4,786.30 | Professional | None | $1,548.82 | $1,737.80 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $3,467.37 Typical High $3,981.07 | Professional | None | $1,659.59 | $3,467.37 | $3,981.07 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,398.83 Typical High $4,897.79 | Professional | None | $1,318.26 | $2,398.83 | $4,897.79 |
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 $794.33 Median $870.96 Typical High $912.01 | Professional | 52 · Reduced service | $794.33 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $346.74 Typical High $363.08 | Professional | 53 · Discontinued | $316.23 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,318.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,174.90 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $263.03 Typical High $269.15 | Professional | 55 · Aftercare only | $234.42 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $173.78 Typical High $181.97 | Professional | 56 · Pre-op care only | $158.49 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,230.27 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,230.27 | $1,258.93 |
Where Washington, DC sits
The same service costs 8.5 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· 32nd of 51
$2,089
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.