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 $1,584.89 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,584.89 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,584.89 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,778.28 Typical High $8,912.51 | Professional | None | $954.99 | $1,778.28 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $4,365.16 | Professional | None | $1,412.54 | $1,513.56 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $3,162.28 Typical High $3,630.78 | Professional | None | $1,445.44 | $3,162.28 | $3,630.78 |
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 $831.76 Median $2,041.74 Typical High $4,365.16 | Professional | None | $831.76 | $2,041.74 | $4,365.16 |
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 $707.95 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,174.90 |
Where Washington, DC sits
The same service costs 8.5 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· 31st of 51
$1,778
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.