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 $1,288.25 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,288.25 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,288.25 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,202.26 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,148.15 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $2,511.89 | Professional | None | $870.96 | $977.24 | $2,511.89 |
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 $870.96 Median $1,023.29 Typical High $2,754.23 | Professional | None | $870.96 | $1,023.29 | $2,754.23 |
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 $602.56 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $891.25 |
Where Washington, DC sits
The same service costs 6.8 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
$1,202
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.