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 $1,174.90 Median $5,011.87 Typical High $10,232.93 | Facility | None | $1,174.90 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,174.90 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $5,754.40 | Professional | None | $1,122.02 | $1,258.93 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $3,235.94 | Professional | None | $1,071.52 | $1,148.15 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $2,691.53 | Professional | None | $1,096.48 | $2,344.23 | $2,691.53 |
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 $891.25 Median $1,659.59 Typical High $3,311.31 | Professional | None | $891.25 | $1,659.59 | $3,311.31 |
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 $549.54 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $851.14 |
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· 38th of 51
$1,259
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.