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 $1,949.84 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,949.84 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,949.84 | $2,089.30 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,698.24 | $2,041.74 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $5,128.61 | Professional | None | $1,659.59 | $1,778.28 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $3,890.45 Typical High $4,466.84 | Professional | None | $1,949.84 | $3,890.45 | $4,466.84 |
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 $1,445.44 Median $2,454.71 Typical High $5,248.07 | Professional | None | $1,445.44 | $2,454.71 | $5,248.07 |
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 $870.96 Median $977.24 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $977.24 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $389.05 Typical High $416.87 | Professional | 53 · Discontinued | $346.74 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $309.03 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $194.98 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,348.96 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,348.96 | $1,445.44 |
Where Washington, DC sits
The same service costs 22.9 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
$1,950
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.