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 $1,659.59 Median $4,073.80 Typical High $8,511.38 | Facility | None | $1,659.59 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $4,168.69 | Professional | None | $1,548.82 | $1,659.59 | $4,168.69 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $12,302.69 | Professional | None | $1,659.59 | $1,819.70 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $4,466.84 | Professional | None | $1,513.56 | $1,621.81 | $4,466.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $3,311.31 Typical High $3,715.35 | Professional | None | $1,548.82 | $3,311.31 | $3,715.35 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $10,471.29 Typical High $42,657.95 | Facility | None | $2,754.23 | $10,471.29 | $42,657.95 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $4,570.88 | Professional | None | $1,258.93 | $2,238.72 | $4,570.88 |
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 $741.31 Median $831.76 Typical High $870.96 | Professional | 52 · Reduced service | $741.31 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $295.12 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $147.91 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,202.26 |
Where Washington, DC sits
The same service costs 7.4 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· 36th of 51
$1,820
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.