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 $3,981.07 Typical High $7,413.10 | Facility | None | $1,698.24 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,778.28 | $1,862.09 |
CareFirst Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $8,912.51 | Professional | None | $1,778.28 | $1,949.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $4,786.30 | Professional | None | $1,621.81 | $1,737.80 | $4,786.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $3,548.13 Typical High $3,981.07 | Professional | None | $1,621.81 | $3,548.13 | $3,981.07 |
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 $1,348.96 Median $2,454.71 Typical High $4,897.79 | Professional | None | $1,348.96 | $2,454.71 | $4,897.79 |
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 $812.83 Median $870.96 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,230.27 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,230.27 | $1,288.25 |
Where Washington, DC sits
The same service costs 9.3 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· 35th of 51
$1,950
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.