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 $1,548.82 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,548.82 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,548.82 | $1,621.81 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $1,737.80 Typical High $8,912.51 | Professional | None | $831.76 | $1,737.80 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $4,265.80 | Professional | None | $1,380.38 | $1,479.11 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $3,090.30 Typical High $3,548.13 | Professional | None | $1,445.44 | $3,090.30 | $3,548.13 |
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 $776.25 Median $1,995.26 Typical High $4,265.80 | Professional | None | $776.25 | $1,995.26 | $4,265.80 |
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 $691.83 Median $776.25 Typical High $812.83 | Professional | 52 · Reduced service | $691.83 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $323.59 | Professional | 53 · Discontinued | $275.42 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,148.15 |
Where Washington, DC sits
The same service costs 8.9 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· 30th of 51
$1,738
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.