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 $1,621.81 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,621.81 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,621.81 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,513.56 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,630.27 | Professional | None | $1,318.26 | $1,445.44 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,348.96 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,318.26 | $3,467.37 |
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 $741.31 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,122.02 |
Where Washington, DC sits
The same service costs 5.1 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
$1,514
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.