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 $1,023.29 Median $5,011.87 Typical High $10,232.93 | Facility | None | $1,023.29 | $5,011.87 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,023.29 Typical High $2,344.23 | Professional | None | $977.24 | $1,023.29 | $2,344.23 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $8,912.51 | Professional | None | $954.99 | $1,071.52 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $2,754.23 | Professional | None | $933.25 | $1,000.00 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $2,041.74 Typical High $2,344.23 | Professional | None | $933.25 | $2,041.74 | $2,344.23 |
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 $794.33 Median $1,445.44 Typical High $2,818.38 | Professional | None | $794.33 | $1,445.44 | $2,818.38 |
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 $467.74 Median $512.86 Typical High $537.03 | Professional | 52 · Reduced service | $467.74 | $512.86 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $213.80 | Professional | 53 · Discontinued | $190.55 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $707.95 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $758.58 |
Where Washington, DC sits
The same service costs 7.8 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
$1,072
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.