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 $1,288.25 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,288.25 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,288.25 | $1,548.82 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $4,570.88 | Professional | None | $1,288.25 | $1,412.54 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,467.37 | Professional | None | $1,148.15 | $1,258.93 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $2,511.89 Typical High $2,884.03 | Professional | None | $1,174.90 | $2,511.89 | $2,884.03 |
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 $954.99 Median $1,698.24 Typical High $3,548.13 | Professional | None | $954.99 | $1,698.24 | $3,548.13 |
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 $588.84 Median $630.96 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $933.25 |
Where Washington, DC sits
The same service costs 7.9 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
$1,413
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.