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 $1,445.44 Median $4,073.80 Typical High $8,511.38 | Facility | None | $1,445.44 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,445.44 | $3,467.37 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $8,912.51 | Professional | None | $1,513.56 | $1,698.24 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $3,890.45 | Professional | None | $1,288.25 | $1,412.54 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $2,818.38 Typical High $3,235.94 | Professional | None | $1,380.38 | $2,818.38 | $3,235.94 |
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 $1,047.13 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,047.13 | $1,949.84 | $3,981.07 |
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 $645.65 Median $707.95 Typical High $741.31 | Professional | 52 · Reduced service | $645.65 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,023.29 |
Where Washington, DC sits
The same service costs 18.2 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· 35th of 51
$1,698
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.