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 $1,148.15 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,148.15 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,148.15 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,202.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $3,019.95 | Professional | None | $660.69 | $1,047.13 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,148.15 | $2,290.87 | $2,630.27 |
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 $691.83 Median $1,479.11 Typical High $3,090.30 | Professional | None | $691.83 | $1,479.11 | $3,090.30 |
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 $489.78 Median $575.44 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $851.14 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $794.33 | $851.14 |
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· 37th of 51
$1,148
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.