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 $2,238.72 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,238.72 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,187.76 | $2,238.72 | $2,238.72 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,137.96 | Professional | None | $1,862.09 | $2,089.30 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,698.24 | $1,995.26 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,621.81 | $1,819.70 | $4,365.16 |
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 $1,479.11 Median $1,819.70 Typical High $4,897.79 | Professional | None | $1,479.11 | $1,819.70 | $4,897.79 |
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 $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,023.29 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $407.38 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,548.82 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $309.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $204.17 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,548.82 | $1,548.82 |
Where Washington, DC sits
The same service costs 5.4 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· 33rd of 51
$2,089
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.