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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,288.25 | $1,412.54 | $1,412.54 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,318.26 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,122.02 | $1,258.93 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,202.26 | $2,754.23 |
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 $912.01 Median $1,148.15 Typical High $3,090.30 | Professional | None | $912.01 | $1,148.15 | $3,090.30 |
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 $645.65 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,000.00 |
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· 34th of 51
$1,318
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.