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 $1,047.13 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,047.13 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | None | $954.99 | $1,047.13 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,047.13 | Professional | None | $912.01 | $1,023.29 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,698.24 | Professional | None | $831.76 | $933.25 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $2,041.74 | Professional | None | $794.33 | $891.25 | $2,041.74 |
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 $676.08 Median $851.14 Typical High $2,290.87 | Professional | None | $676.08 | $851.14 | $2,290.87 |
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 $478.63 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $724.44 |
Where Washington, DC sits
The same service costs 5.0 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
$1,000
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.