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 $1,318.26 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,318.26 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,348.96 | Professional | None | $1,288.25 | $1,318.26 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,230.27 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,174.90 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,122.02 | $2,570.40 |
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 $870.96 Median $1,071.52 Typical High $2,884.03 | Professional | None | $870.96 | $1,071.52 | $2,884.03 |
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 $616.60 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $933.25 |
Where Washington, DC sits
The same service costs 5.1 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
$1,230
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.