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 $4,168.69 Typical High $10,232.93 | Facility | None | $1,380.38 | $4,168.69 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,380.38 | $1,380.38 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,230.27 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,230.27 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $2,398.83 | Professional | None | $954.99 | $1,071.52 | $2,398.83 |
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 $977.24 Median $1,122.02 Typical High $3,019.95 | Professional | None | $977.24 | $1,122.02 | $3,019.95 |
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 $645.65 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $645.65 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $977.24 |
Where Washington, DC sits
The same service costs 6.5 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· 44th of 51
$1,230
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.