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 $1,230.27 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,230.27 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $2,951.21 | Professional | None | $1,174.90 | $1,230.27 | $2,951.21 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $4,570.88 | Professional | None | $1,258.93 | $1,380.38 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $3,388.44 | Professional | None | $1,096.48 | $1,202.26 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $2,398.83 Typical High $2,818.38 | Professional | None | $1,148.15 | $2,398.83 | $2,818.38 |
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 $1,698.24 Typical High $3,388.44 | Professional | None | $912.01 | $1,698.24 | $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 $575.44 Median $616.60 Typical High $645.65 | Professional | 52 · Reduced service | $575.44 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $257.04 | Professional | 53 · Discontinued | $229.09 | $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 $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $128.82 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $128.82 |
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 7.9 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
$1,380
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.