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 $3,548.13 Typical High $4,786.30 | Facility | None | $1,698.24 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,737.80 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $1,737.80 Typical High $1,949.84 | Professional | None | $630.96 | $1,737.80 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $4,677.35 | Professional | None | $1,513.56 | $1,698.24 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $3,311.31 Typical High $3,890.45 | Professional | None | $1,621.81 | $3,311.31 | $3,890.45 |
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 $1,202.26 Median $2,290.87 Typical High $4,786.30 | Professional | None | $1,202.26 | $2,290.87 | $4,786.30 |
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 $758.58 Median $870.96 Typical High $891.25 | Professional | 52 · Reduced service | $758.58 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $346.74 Typical High $363.08 | Professional | 53 · Discontinued | $302.00 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,318.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,122.02 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $263.03 Typical High $269.15 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $173.78 Typical High $181.97 | Professional | 56 · Pre-op care only | $151.36 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,230.27 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,230.27 | $1,258.93 |
Where Washington, DC sits
The same service costs 7.8 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
$1,738
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.