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 $831.76 Median $5,011.87 Typical High $10,232.93 | Facility | None | $831.76 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,905.46 | Professional | None | $794.33 | $831.76 | $1,905.46 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $7,244.36 | Professional | None | $776.25 | $870.96 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $2,290.87 | Professional | None | $758.58 | $812.83 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,621.81 Typical High $1,905.46 | Professional | None | $741.31 | $1,621.81 | $1,905.46 |
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 $616.60 Median $1,096.48 Typical High $2,290.87 | Professional | None | $616.60 | $1,096.48 | $2,290.87 |
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 $389.05 Median $416.87 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $602.56 |
Where Washington, DC sits
The same service costs 7.9 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· 38th of 51
$871
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.