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 $1,122.02 Median $4,073.80 Typical High $7,079.46 | Facility | None | $1,122.02 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,122.02 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $6,309.57 | Professional | None | $1,000.00 | $1,122.02 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,047.13 | $2,884.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $2,570.40 | Professional | None | $1,000.00 | $2,238.72 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,479.11 Typical High $3,019.95 | Professional | None | $891.25 | $1,479.11 | $3,019.95 |
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 $537.03 Median $562.34 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $245.47 | Professional | 53 · Discontinued | $213.80 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $831.76 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $776.25 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $776.25 | $851.14 |
Where Washington, DC sits
The same service costs 6.3 times more in Alaska than in Utah. 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
$1,175
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.