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 $1,698.24 Median $5,011.87 Typical High $10,232.93 | Facility | None | $1,698.24 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,819.70 | $1,905.46 |
CareFirst Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $11,220.18 | Professional | None | $1,737.80 | $1,949.84 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $5,011.87 | Professional | None | $1,659.59 | $1,737.80 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $3,630.78 Typical High $4,168.69 | Professional | None | $1,659.59 | $3,630.78 | $4,168.69 |
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 $1,584.89 Median $2,630.27 Typical High $5,011.87 | Professional | None | $1,584.89 | $2,630.27 | $5,011.87 |
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 $851.14 Median $912.01 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 53 · Discontinued | $338.84 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $275.42 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,288.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,288.25 | $1,348.96 |
Where Washington, DC sits
The same service costs 9.1 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· 39th of 51
$1,950
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.