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 $3,388.44 Typical High $7,943.28 | Facility | None | $1,412.54 | $3,388.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,388.44 Typical High $3,548.13 | Professional | None | $3,019.95 | $3,388.44 | $3,548.13 |
CareFirst Setting Professional Modifier None Typical Low $3,467.37 Median $3,801.89 Typical High $18,197.01 | Professional | None | $3,467.37 | $3,801.89 | $18,197.01 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $9,120.11 | Professional | None | $2,691.53 | $3,311.31 | $9,120.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,019.95 Median $6,760.83 Typical High $7,585.78 | Professional | None | $3,019.95 | $6,760.83 | $7,585.78 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $2,398.83 Median $4,786.30 Typical High $9,332.54 | Professional | None | $2,398.83 | $4,786.30 | $9,332.54 |
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 $1,513.56 Median $1,659.59 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,513.56 | $1,659.59 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $676.08 Typical High $707.95 | Professional | 53 · Discontinued | $602.56 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,511.89 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,290.87 | $2,511.89 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $501.19 Typical High $537.03 | Professional | 55 · Aftercare only | $457.09 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $338.84 Typical High $354.81 | Professional | 56 · Pre-op care only | $302.00 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,344.23 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,344.23 | $2,511.89 |
Where Washington, DC sits
The same service costs 20.4 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· 35th of 51
$3,802
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.