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 $1,445.44 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,445.44 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,445.44 | $3,467.37 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $8,912.51 | Professional | None | $1,380.38 | $1,621.81 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $3,981.07 | Professional | None | $1,318.26 | $1,412.54 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $3,311.31 | Professional | None | $1,318.26 | $2,884.03 | $3,311.31 |
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 $1,096.48 Median $1,905.46 Typical High $3,981.07 | Professional | None | $1,096.48 | $1,905.46 | $3,981.07 |
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 $676.08 Median $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,071.52 |
Where Washington, DC sits
The same service costs 18.6 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
$1,622
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.