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 $1,318.26 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,318.26 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,318.26 | $3,090.30 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $1,445.44 Typical High $1,659.59 | Professional | None | $630.96 | $1,445.44 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $3,630.78 | Professional | None | $1,174.90 | $1,258.93 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $2,630.27 Typical High $3,019.95 | Professional | None | $1,202.26 | $2,630.27 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,862.09 Typical High $3,630.78 | Professional | None | $1,096.48 | $1,862.09 | $3,630.78 |
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 $616.60 Median $660.69 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $1,000.00 |
Where Washington, DC sits
The same service costs 8.1 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
$1,445
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.