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 $1,096.48 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,096.48 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,096.48 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $7,244.36 | Professional | None | $1,047.13 | $1,174.90 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $3,019.95 | Professional | None | $977.24 | $1,047.13 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,023.29 | $2,137.96 | $2,511.89 |
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 $1,548.82 Typical High $3,019.95 | Professional | None | $812.83 | $1,548.82 | $3,019.95 |
4 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 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $794.33 |
Where Washington, DC sits
The same service costs 7.6 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· 36th of 51
$1,175
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.