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 $1,258.93 Median $4,073.80 Typical High $7,079.46 | Facility | None | $1,258.93 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,258.93 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,258.93 | $3,162.28 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $9,772.37 | Professional | None | $1,202.26 | $1,318.26 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $3,467.37 | Professional | None | $1,202.26 | $1,230.27 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $2,884.03 | Professional | None | $1,148.15 | $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 $1,023.29 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,023.29 | $1,778.28 | $3,467.37 |
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 $676.08 | Professional | 52 · Reduced service | $588.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $954.99 |
Where Washington, DC sits
The same service costs 7.6 times more in Alaska than in Utah. 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· 39th of 51
$1,318
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.