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 $1,949.84 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,949.84 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,778.28 | $1,949.84 | $1,949.84 |
CareFirst Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,819.70 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,548.82 | $1,737.80 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $3,715.35 | Professional | None | $1,479.11 | $1,659.59 | $3,715.35 |
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 $1,258.93 Median $1,584.89 Typical High $4,168.69 | Professional | None | $1,258.93 | $1,584.89 | $4,168.69 |
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 $891.25 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $891.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,348.96 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,348.96 | $1,348.96 |
Where Washington, DC sits
The same service costs 20.4 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
$1,820
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.