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 $1,348.96 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,348.96 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $3,311.31 | Professional | None | $1,288.25 | $1,348.96 | $3,311.31 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $7,943.28 | Professional | None | $1,122.02 | $1,412.54 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $3,715.35 | Professional | None | $1,202.26 | $1,318.26 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $3,019.95 | Professional | None | $1,230.27 | $2,630.27 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,000.00 | $1,819.70 | $3,715.35 |
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 $691.83 | Professional | 52 · Reduced service | $616.60 | $660.69 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,047.13 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $977.24 |
Where Washington, DC sits
The same service costs 7.9 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· 38th of 51
$1,413
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.