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 $2,137.96 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,137.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $2,344.23 | Professional | None | $1,949.84 | $2,137.96 | $2,344.23 |
CareFirst Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $8,912.51 | Professional | None | $2,187.76 | $2,398.83 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,089.30 Typical High $5,754.40 | Professional | None | $2,041.74 | $2,089.30 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $4,265.80 Typical High $4,786.30 | Professional | None | $1,905.46 | $4,265.80 | $4,786.30 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $3,019.95 Typical High $5,888.44 | Professional | None | $1,737.80 | $3,019.95 | $5,888.44 |
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 $977.24 Median $1,071.52 Typical High $1,174.90 | Professional | 52 · Reduced service | $977.24 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 53 · Discontinued | $389.05 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,584.89 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,479.11 | $1,584.89 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $346.74 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | 56 · Pre-op care only | $194.98 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,479.11 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,479.11 | $1,621.81 |
Where Washington, DC sits
The same service costs 19.5 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· 36th of 51
$2,399
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.