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 $2,041.74 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,041.74 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,819.70 | $2,041.74 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,905.46 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,548.82 | $1,819.70 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,513.56 | $1,698.24 | $3,981.07 |
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 $1,348.96 Median $1,659.59 Typical High $4,466.84 | Professional | None | $1,348.96 | $1,659.59 | $4,466.84 |
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 $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $933.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $380.19 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,445.44 |
Where Washington, DC sits
The same service costs 4.9 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· 33rd of 51
$1,905
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.