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 $1,412.54 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,778.28 | Professional | None | $1,548.82 | $1,698.24 | $1,778.28 |
CareFirst Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $18,197.01 | Professional | None | $1,659.59 | $1,819.70 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $4,570.88 | Professional | None | $1,513.56 | $1,659.59 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $3,311.31 Typical High $3,801.89 | Professional | None | $1,548.82 | $3,311.31 | $3,801.89 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $4,677.35 | Professional | None | $1,258.93 | $2,290.87 | $4,677.35 |
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 $776.25 Median $831.76 Typical High $891.25 | Professional | 52 · Reduced service | $776.25 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $354.81 | Professional | 53 · Discontinued | $309.03 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,258.93 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $251.19 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,174.90 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,174.90 | $1,230.27 |
Where Washington, DC sits
The same service costs 20.4 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· 38th of 51
$1,820
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.