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 $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,548.82 | $1,548.82 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,445.44 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,380.38 | $2,511.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,288.25 | $2,951.21 |
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 $1,000.00 Median $1,258.93 Typical High $3,311.31 | Professional | None | $1,000.00 | $1,258.93 | $3,311.31 |
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 $707.95 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,071.52 |
Where Washington, DC sits
The same service costs 21.4 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
$1,445
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.