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 $1,348.96 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,348.96 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,258.93 | $1,348.96 | $1,348.96 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,148.15 | $1,258.93 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,202.26 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $2,630.27 | Professional | None | $1,023.29 | $1,148.15 | $2,630.27 |
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 $1,096.48 Typical High $2,951.21 | Professional | None | $870.96 | $1,096.48 | $2,951.21 |
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 $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $616.60 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $954.99 |
Where Washington, DC sits
The same service costs 5.6 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· 33rd of 51
$1,259
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.