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 $1,698.24 Median $4,073.80 Typical High $7,079.46 | Facility | None | $1,698.24 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $3,090.30 Typical High $3,235.94 | Professional | None | $2,754.23 | $3,090.30 | $3,235.94 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $3,235.94 Typical High $3,981.07 | Professional | None | $630.96 | $3,235.94 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,019.95 Typical High $8,511.38 | Professional | None | $2,570.40 | $3,019.95 | $8,511.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $6,165.95 Typical High $6,918.31 | Professional | None | $2,818.38 | $6,165.95 | $6,918.31 |
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 $2,187.76 Median $4,265.80 Typical High $8,511.38 | Professional | None | $2,187.76 | $4,265.80 | $8,511.38 |
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 $1,380.38 Median $1,548.82 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,380.38 | $1,548.82 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $616.60 Typical High $660.69 | Professional | 53 · Discontinued | $549.54 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,290.87 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,089.30 | $2,290.87 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $467.74 Typical High $489.78 | Professional | 55 · Aftercare only | $416.87 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $309.03 Typical High $323.59 | Professional | 56 · Pre-op care only | $275.42 | $309.03 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,137.96 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,137.96 | $2,290.87 |
Where Washington, DC sits
The same service costs 19.1 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
$3,236
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.