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 $1,047.13 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,047.13 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,096.48 | Professional | None | $977.24 | $1,047.13 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $12,302.69 | Professional | None | $1,000.00 | $1,122.02 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $2,884.03 | Professional | None | $933.25 | $1,023.29 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $2,041.74 Typical High $2,398.83 | Professional | None | $977.24 | $2,041.74 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $2,884.03 | Professional | None | $776.25 | $1,479.11 | $2,884.03 |
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 $489.78 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $489.78 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $194.98 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $724.44 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $144.54 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $676.08 | $741.31 | $758.58 |
Where Washington, DC sits
The same service costs 8.5 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
$1,122
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.