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 $2,818.38 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,818.38 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,630.27 | $2,818.38 | $2,818.38 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $3,311.31 | Professional | None | $2,570.40 | $2,951.21 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $7,413.10 | Professional | None | $2,511.89 | $2,570.40 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,754.23 Median $5,754.40 Typical High $6,456.54 | Professional | None | $2,754.23 | $5,754.40 | $6,456.54 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,715.35 Typical High $7,762.47 | Professional | None | $2,137.96 | $3,715.35 | $7,762.47 |
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 $1,380.38 Median $1,412.54 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,380.38 | $1,412.54 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $562.34 Typical High $616.60 | Professional | 53 · Discontinued | $549.54 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,137.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,041.74 | $2,137.96 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $426.58 Typical High $467.74 | Professional | 55 · Aftercare only | $416.87 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $281.84 Typical High $309.03 | Professional | 56 · Pre-op care only | $275.42 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,995.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,995.26 | $2,137.96 |
Where Washington, DC sits
The same service costs 24.0 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· 39th of 51
$2,818
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.