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 $2,290.87 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,290.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $5,623.41 | Professional | None | $2,187.76 | $2,290.87 | $5,623.41 |
CareFirst Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,630.27 | Professional | None | $1,949.84 | $2,398.83 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,041.74 Typical High $6,025.60 | Professional | None | $1,949.84 | $2,041.74 | $6,025.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $4,570.88 Typical High $5,248.07 | Professional | None | $2,238.72 | $4,570.88 | $5,248.07 |
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 $1,698.24 Median $2,951.21 Typical High $6,165.95 | Professional | None | $1,698.24 | $2,951.21 | $6,165.95 |
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 $1,023.29 Median $1,122.02 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,023.29 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $457.09 Typical High $489.78 | Professional | 53 · Discontinued | $407.38 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,698.24 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,548.82 | $1,698.24 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $338.84 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | 56 · Pre-op care only | $204.17 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,584.89 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,584.89 | $1,698.24 |
Where Washington, DC sits
The same service costs 21.9 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· 38th of 51
$2,291
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.