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 $645.65 Median $3,388.44 Typical High $6,606.93 | Facility | None | $645.65 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $660.69 | Professional | None | $602.56 | $645.65 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $6,309.57 | Professional | None | $616.60 | $676.08 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $1,778.28 | Professional | None | $575.44 | $630.96 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,479.11 | Professional | None | $616.60 | $1,230.27 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $1,778.28 | Professional | None | $467.74 | $891.25 | $1,778.28 |
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 $295.12 Median $323.59 Typical High $331.13 | Professional | 52 · Reduced service | $295.12 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $131.83 | Professional | 53 · Discontinued | $120.23 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $446.68 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $66.07 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $416.87 | $446.68 | $457.09 |
Where Washington, DC sits
The same service costs 7.9 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
$676
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.