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 $1,148.15 Median $4,073.80 Typical High $7,079.46 | Facility | None | $1,148.15 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,148.15 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $13,489.63 Median $15,848.93 Typical High $35,481.34 | Professional | None | $13,489.63 | $15,848.93 | $35,481.34 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $3,162.28 | Professional | None | $977.24 | $1,096.48 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,122.02 | $2,187.76 | $2,570.40 |
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 $741.31 Median $1,584.89 Typical High $3,162.28 | Professional | None | $741.31 | $1,584.89 | $3,162.28 |
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 $524.81 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $524.81 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $870.96 | Professional | 54 · Surgery only | $794.33 | $851.14 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $173.78 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $812.83 |
Where Washington, DC sits
The same service costs 46.8 times more in Alaska than in Hawaii. 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· 34th of 51
$1,413
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.