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 $3,388.44 Typical High $7,943.28 | Facility | None | $1,412.54 | $3,388.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,235.94 | $3,388.44 | $3,388.44 |
CareFirst Setting Professional Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $3,548.13 | Professional | None | $2,951.21 | $3,235.94 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,162.28 Typical High $5,754.40 | Professional | None | $2,691.53 | $3,162.28 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $6,760.83 | Professional | None | $2,570.40 | $2,884.03 | $6,760.83 |
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 $2,290.87 Median $2,884.03 Typical High $7,585.78 | Professional | None | $2,290.87 | $2,884.03 | $7,585.78 |
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 $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,621.81 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $645.65 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,398.83 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $489.78 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,398.83 | $2,398.83 |
Where Washington, DC sits
The same service costs 5.2 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
$3,236
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.