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 $2,290.87 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,290.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,041.74 | $2,290.87 | $2,290.87 |
CareFirst Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $2,290.87 | Professional | None | $1,905.46 | $2,089.30 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,041.74 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $4,365.16 | Professional | None | $1,659.59 | $1,862.09 | $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 $1,513.56 Median $1,862.09 Typical High $4,897.79 | Professional | None | $1,513.56 | $1,862.09 | $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 $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,047.13 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $416.87 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,584.89 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,584.89 | $1,584.89 |
Where Washington, DC sits
The same service costs 4.8 times more in Wyoming 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· 35th 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.