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 $691.83 Median $4,073.80 Typical High $7,079.46 | Facility | None | $691.83 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $758.58 | Professional | None | $660.69 | $691.83 | $758.58 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $4,570.88 | Professional | None | $691.83 | $776.25 | $4,570.88 |
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 $691.83 Median $1,348.96 Typical High $1,584.89 | Professional | None | $691.83 | $1,348.96 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $1,905.46 | Professional | None | $524.81 | $977.24 | $1,905.46 |
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 $331.13 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $331.13 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $131.83 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $501.19 |
Where Washington, DC sits
The same service costs 7.2 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
$776
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.