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 $3,548.13 Typical High $4,786.30 | Facility | None | $1,148.15 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,148.15 | $1,258.93 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,258.93 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,047.13 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,071.52 | $2,290.87 | $2,630.27 |
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 $870.96 Median $1,513.56 Typical High $3,162.28 | Professional | None | $870.96 | $1,513.56 | $3,162.28 |
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 $549.54 Median $575.44 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $251.19 | Professional | 53 · Discontinued | $218.78 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $954.99 | Professional | 54 · Surgery only | $831.76 | $851.14 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $173.78 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $125.89 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $891.25 |
Where Washington, DC sits
The same service costs 6.2 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· 36th of 51
$1,259
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.