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 $1,288.25 Median $3,548.13 Typical High $4,786.30 | Facility | None | $1,288.25 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,148.15 | $1,288.25 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,148.15 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,089.30 | Professional | None | $977.24 | $1,148.15 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $2,511.89 | Professional | None | $977.24 | $1,096.48 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $2,818.38 | Professional | None | $812.83 | $1,023.29 | $2,818.38 |
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 $602.56 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $912.01 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $891.25 |
Where Washington, DC sits
The same service costs 5.2 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· 35th of 51
$1,148
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.