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 $2,884.03 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,884.03 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,691.53 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,691.53 | $2,884.03 | $2,884.03 |
CareFirst Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,754.23 | Professional | None | $2,398.83 | $2,691.53 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,290.87 | $2,570.40 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $5,495.41 | Professional | None | $2,137.96 | $2,398.83 | $5,495.41 |
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 $1,905.46 Median $2,344.23 Typical High $6,165.95 | Professional | None | $1,905.46 | $2,344.23 | $6,165.95 |
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 $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $537.03 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,995.26 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,995.26 | $1,995.26 |
Where Washington, DC sits
The same service costs 21.4 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· 34th of 51
$2,692
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.