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 $1,548.82 Median $3,890.45 Typical High $8,511.38 | Facility | None | $1,548.82 | $3,890.45 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $3,890.45 | Professional | None | $1,445.44 | $1,548.82 | $3,890.45 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $7,244.36 | Professional | None | $1,513.56 | $1,659.59 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $4,073.80 | Professional | None | $1,348.96 | $1,412.54 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $3,090.30 Typical High $3,548.13 | Professional | None | $1,479.11 | $3,090.30 | $3,548.13 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $2,041.74 Typical High $4,168.69 | Professional | None | $1,148.15 | $2,041.74 | $4,168.69 |
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 $741.31 Median $776.25 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,174.90 |
Where Washington, DC sits
The same service costs 7.2 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· 39th of 51
$1,660
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.