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 $1,122.02 Median $4,168.69 Typical High $10,232.93 | Facility | None | $1,122.02 | $4,168.69 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,122.02 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $10,000.00 | Professional | None | $1,071.52 | $1,174.90 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $3,019.95 | Professional | None | $1,000.00 | $1,096.48 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,023.29 | $2,137.96 | $2,511.89 |
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 $831.76 Median $1,584.89 Typical High $3,090.30 | Professional | None | $831.76 | $1,584.89 | $3,090.30 |
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 $512.86 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $234.42 | Professional | 53 · Discontinued | $204.17 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $776.25 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $724.44 | $776.25 | $812.83 |
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· 39th of 51
$1,175
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.