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 $724.44 Median $3,981.07 Typical High $7,413.10 | Facility | None | $724.44 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | None | $660.69 | $724.44 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $8,128.31 | Professional | None | $676.08 | $758.58 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,995.26 | Professional | None | $630.96 | $707.95 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $1,412.54 Typical High $1,621.81 | Professional | None | $660.69 | $1,412.54 | $1,621.81 |
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 $524.81 Median $954.99 Typical High $1,995.26 | Professional | None | $524.81 | $954.99 | $1,995.26 |
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 $338.84 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $338.84 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $134.90 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $524.81 |
Where Washington, DC sits
The same service costs 9.5 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· 39th of 51
$759
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.