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 $1,148.15 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,148.15 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $1,148.15 Typical High $1,445.44 | Professional | None | $630.96 | $1,148.15 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $3,162.28 | Professional | None | $1,000.00 | $1,122.02 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,071.52 | $2,238.72 | $2,630.27 |
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 $812.83 Median $1,479.11 Typical High $3,162.28 | Professional | None | $812.83 | $1,479.11 | $3,162.28 |
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 $501.19 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $812.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $812.83 | $831.76 |
Where Washington, DC sits
The same service costs 13.8 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· 37th of 51
$1,148
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.