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 $1,380.38 Median $3,311.31 Typical High $7,413.10 | Facility | None | $1,380.38 | $3,311.31 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,380.38 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $4,570.88 | Professional | None | $1,000.00 | $1,230.27 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $4,168.69 | Professional | None | $1,258.93 | $1,621.81 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,737.80 | $1,819.70 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $4,168.69 | Professional | None | $1,122.02 | $1,995.26 | $4,168.69 |
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 $630.96 Median $691.83 Typical High $912.01 | Professional | 52 · Reduced service | $630.96 | $691.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $363.08 | Professional | 53 · Discontinued | $251.19 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,348.96 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $181.97 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,258.93 |
Where Washington, DC sits
The same service costs 5.2 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· 33rd of 51
$1,698
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.