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 $1,778.28 Median $1,949.84 Typical High $1,995.26 | Professional | None | $1,778.28 | $1,949.84 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $7,244.36 | Professional | None | $1,949.84 | $2,137.96 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $5,370.32 | Professional | None | $1,778.28 | $1,905.46 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $3,890.45 Typical High $4,365.16 | Professional | None | $1,778.28 | $3,890.45 | $4,365.16 |
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 $1,479.11 Median $2,691.53 Typical High $5,370.32 | Professional | None | $1,479.11 | $2,691.53 | $5,370.32 |
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 $891.25 Median $977.24 Typical High $1,023.29 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $407.38 | Professional | 53 · Discontinued | $354.81 | $389.05 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,445.44 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,348.96 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $288.40 Typical High $309.03 | Professional | 55 · Aftercare only | $269.15 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $204.17 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,348.96 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,348.96 | $1,445.44 |
Where Washington, DC sits
The same service costs 17.8 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· 36th of 51
$2,138
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.