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 $933.25 Median $3,981.07 Typical High $7,413.10 | Facility | None | $933.25 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $933.25 Typical High $2,238.72 | Professional | None | $891.25 | $933.25 | $2,238.72 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $5,011.87 | Professional | None | $891.25 | $1,000.00 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $2,570.40 | Professional | None | $831.76 | $933.25 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,819.70 Typical High $2,137.96 | Professional | None | $870.96 | $1,819.70 | $2,137.96 |
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 $691.83 Median $1,288.25 Typical High $2,570.40 | Professional | None | $691.83 | $1,288.25 | $2,570.40 |
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 $436.52 Median $467.74 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $467.74 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $676.08 |
Where Washington, DC sits
The same service costs 7.1 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· 37th of 51
$1,000
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.