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 $4,073.80 Typical High $7,079.46 | Facility | None | $1,698.24 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,981.07 Typical High $4,168.69 | Professional | None | $3,630.78 | $3,981.07 | $4,168.69 |
CareFirst Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $8,912.51 | Professional | None | $3,890.45 | $4,365.16 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $10,715.19 | Professional | None | $2,951.21 | $3,801.89 | $10,715.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,630.78 Median $7,762.47 Typical High $8,912.51 | Professional | None | $3,630.78 | $7,762.47 | $8,912.51 |
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 $2,818.38 Median $5,623.41 Typical High $10,964.78 | Professional | None | $2,818.38 | $5,623.41 | $10,964.78 |
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 $1,819.70 Median $1,995.26 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,819.70 | $1,995.26 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $794.33 Typical High $831.76 | Professional | 53 · Discontinued | $724.44 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,951.21 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,691.53 | $2,951.21 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $588.84 Typical High $630.96 | Professional | 55 · Aftercare only | $549.54 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $398.11 Typical High $416.87 | Professional | 56 · Pre-op care only | $363.08 | $398.11 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,754.23 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,754.23 | $2,884.03 |
Where Washington, DC sits
The same service costs 20.4 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· 33rd of 51
$4,365
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.