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 $1,202.26 Median $4,073.80 Typical High $7,079.46 | Facility | None | $1,202.26 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,174.90 | $1,202.26 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $4,570.88 | Professional | None | $1,230.27 | $1,348.96 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $3,311.31 | Professional | None | $1,096.48 | $1,202.26 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $2,398.83 Typical High $2,754.23 | Professional | None | $1,122.02 | $2,398.83 | $2,754.23 |
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 $912.01 Median $1,659.59 Typical High $3,388.44 | Professional | None | $912.01 | $1,659.59 | $3,388.44 |
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 $562.34 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $851.14 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $891.25 |
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· 35th of 51
$1,349
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.