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 $1,513.56 Median $5,011.87 Typical High $10,232.93 | Facility | None | $1,513.56 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,318.26 | $1,513.56 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $10,000.00 | Professional | None | $1,445.44 | $1,584.89 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $4,168.69 | Professional | None | $1,412.54 | $1,479.11 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $2,951.21 Typical High $3,388.44 | Professional | None | $1,348.96 | $2,951.21 | $3,388.44 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $4,168.69 | Professional | None | $1,174.90 | $1,995.26 | $4,168.69 |
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 $741.31 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $741.31 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $302.00 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,096.48 |
Where Washington, DC sits
The same service costs 8.7 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
$1,585
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.