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 $3,548.13 Typical High $7,943.28 | Facility | None | $1,412.54 | $3,548.13 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,467.37 | $3,548.13 | $3,548.13 |
CareFirst Setting Professional Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $3,801.89 | Professional | None | $3,019.95 | $3,311.31 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,162.28 Typical High $5,888.44 | Professional | None | $2,951.21 | $3,162.28 | $5,888.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $6,918.31 | Professional | None | $2,630.27 | $2,951.21 | $6,918.31 |
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 $2,344.23 Median $2,951.21 Typical High $7,762.47 | Professional | None | $2,344.23 | $2,951.21 | $7,762.47 |
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 $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,659.59 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,511.89 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $331.13 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,511.89 | $2,511.89 |
Where Washington, DC sits
The same service costs 5.9 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
$3,311
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.