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 $4,073.80 Typical High $7,943.28 | Facility | None | $1,412.54 | $4,073.80 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $4,570.88 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,570.88 | $4,897.79 | $4,897.79 |
CareFirst Setting Professional Modifier None Typical Low $4,168.69 Median $4,677.35 Typical High $4,786.30 | Professional | None | $4,168.69 | $4,677.35 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $4,466.84 Typical High $7,762.47 | Professional | None | $4,073.80 | $4,466.84 | $7,762.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,715.35 Median $4,168.69 Typical High $9,549.93 | Professional | None | $3,715.35 | $4,168.69 | $9,549.93 |
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 $3,019.95 Median $4,073.80 Typical High $10,715.19 | Professional | None | $3,019.95 | $4,073.80 | $10,715.19 |
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 $2,290.87 Median $2,454.71 Typical High $2,454.71 | Professional | 52 · Reduced service | $2,290.87 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $3,715.35 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,467.37 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | 55 · Aftercare only | $691.83 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $457.09 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,467.37 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,467.37 | $3,467.37 |
Where Washington, DC sits
The same service costs 20.9 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· 34th of 51
$4,571
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.