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 $1,318.26 Median $3,548.13 Typical High $4,786.30 | Facility | None | $1,318.26 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,318.26 | $1,445.44 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $12,302.69 | Professional | None | $1,230.27 | $1,380.38 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $3,467.37 | Professional | None | $1,174.90 | $1,202.26 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $2,630.27 Typical High $3,019.95 | Professional | None | $1,174.90 | $2,630.27 | $3,019.95 |
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 $1,023.29 Median $1,698.24 Typical High $3,548.13 | Professional | None | $1,023.29 | $1,698.24 | $3,548.13 |
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 $630.96 Median $660.69 Typical High $724.44 | Professional | 52 · Reduced service | $630.96 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $251.19 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $144.54 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $1,000.00 |
Where Washington, DC sits
The same service costs 7.4 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
$1,380
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.