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 $1,380.38 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,380.38 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,380.38 | $1,479.11 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $3,235.94 | Professional | None | $1,047.13 | $1,548.82 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $4,073.80 | Professional | None | $1,258.93 | $1,412.54 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $3,388.44 | Professional | None | $1,348.96 | $2,754.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,778.28 Typical High $4,073.80 | Professional | None | $870.96 | $1,778.28 | $4,073.80 |
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 $602.56 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $181.97 | $208.93 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $851.14 | $977.24 | $1,023.29 |
Where Washington, DC sits
The same service costs 9.1 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· 33rd of 51
$1,514
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.