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 $1,258.93 Median $5,011.87 Typical High $10,232.93 | Facility | None | $1,258.93 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,258.93 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,174.90 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,148.15 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $2,454.71 | Professional | None | $954.99 | $1,071.52 | $2,454.71 |
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 $831.76 Median $1,047.13 Typical High $2,754.23 | Professional | None | $831.76 | $1,047.13 | $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 $588.84 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $891.25 |
Where Washington, DC sits
The same service costs 4.9 times more in Alaska than in Utah. 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
$1,175
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.