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 $4,073.80 Typical High $7,943.28 | Facility | None | $1,412.54 | $4,073.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,890.45 | $4,073.80 | $4,073.80 |
CareFirst Setting Professional Modifier None Typical Low $3,467.37 Median $3,801.89 Typical High $4,168.69 | Professional | None | $3,467.37 | $3,801.89 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,630.78 Typical High $7,244.36 | Professional | None | $3,090.30 | $3,630.78 | $7,244.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,090.30 Median $3,467.37 Typical High $7,413.10 | Professional | None | $3,090.30 | $3,467.37 | $7,413.10 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,412.54 Typical High $6,309.57 | Facility | None | $426.58 | $1,412.54 | $6,309.57 |
United Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $8,912.51 | Professional | None | $2,884.03 | $3,388.44 | $8,912.51 |
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 $1,949.84 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,949.84 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,884.03 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $575.44 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $389.05 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,884.03 | $2,884.03 |
Where Washington, DC sits
The same service costs 21.9 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· 35th of 51
$3,802
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.