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 $1,905.46 Median $2,089.30 Typical High $2,290.87 | Professional | None | $1,905.46 | $2,089.30 | $2,290.87 |
CareFirst Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $18,197.01 | Professional | None | $2,041.74 | $2,511.89 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $5,623.41 | Professional | None | $1,905.46 | $2,041.74 | $5,623.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $4,265.80 Typical High $4,677.35 | Professional | None | $1,862.09 | $4,265.80 | $4,677.35 |
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 $1,584.89 Median $2,951.21 Typical High $5,754.40 | Professional | None | $1,584.89 | $2,951.21 | $5,754.40 |
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 $954.99 Median $1,023.29 Typical High $1,122.02 | Professional | 52 · Reduced service | $954.99 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $416.87 Typical High $457.09 | Professional | 53 · Discontinued | $380.19 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $309.03 Typical High $338.84 | Professional | 55 · Aftercare only | $288.40 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $1,584.89 |
Where Washington, DC sits
The same service costs 21.9 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
$2,512
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.