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 $4,073.80 Typical High $7,079.46 | Facility | None | $1,122.02 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,174.90 | Professional | None | $977.24 | $1,122.02 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $5,128.61 | Professional | None | $831.76 | $1,174.90 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $3,019.95 | Professional | None | $933.25 | $1,047.13 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,071.52 | $2,041.74 | $2,511.89 |
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 $758.58 Median $1,479.11 Typical High $3,090.30 | Professional | None | $758.58 | $1,479.11 | $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 $489.78 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $776.25 | $776.25 |
Where Washington, DC sits
The same service costs 7.2 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· 32nd 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.