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 $1,122.02 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,122.02 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,122.02 | $2,818.38 |
CareFirst Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $12,302.69 | Professional | None | $1,071.52 | $1,174.90 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $3,090.30 | Professional | None | $933.25 | $1,071.52 | $3,090.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,071.52 | $2,041.74 | $2,570.40 |
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 $776.25 Median $1,445.44 Typical High $3,090.30 | Professional | None | $776.25 | $1,445.44 | $3,090.30 |
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 $501.19 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $501.19 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $204.17 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $794.33 |
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· 37th of 51
$1,175
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.