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 $1,412.54 Median $2,570.40 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,570.40 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,344.23 | $2,570.40 | $2,570.40 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,344.23 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,238.72 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $4,466.84 | Professional | None | $1,819.70 | $2,041.74 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,698.24 | $2,041.74 | $5,495.41 |
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 $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,174.90 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,778.28 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $354.81 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,778.28 | $1,778.28 |
Where Washington, DC sits
The same service costs 5.4 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
$2,344
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.