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 $3,548.13 Typical High $4,786.30 | Facility | None | $1,318.26 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,318.26 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $549.54 Median $1,380.38 Typical High $4,073.80 | Professional | None | $549.54 | $1,380.38 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,258.93 Typical High $3,548.13 | Professional | None | $575.44 | $1,258.93 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $2,570.40 Typical High $2,951.21 | Professional | None | $1,202.26 | $2,570.40 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $501.19 Median $1,698.24 Typical High $3,630.78 | Professional | None | $501.19 | $1,698.24 | $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 $575.44 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $263.03 Typical High $275.42 | Professional | 53 · Discontinued | $229.09 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $954.99 |
Where Washington, DC sits
The same service costs 8.3 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· 28th of 51
$1,380
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.