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 $954.99 Median $3,548.13 Typical High $4,786.30 | Facility | None | $954.99 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,148.15 | Professional | None | $912.01 | $954.99 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $7,244.36 | Professional | None | $691.83 | $1,096.48 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $2,691.53 | Professional | None | $870.96 | $954.99 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,862.09 Typical High $2,187.76 | Professional | None | $933.25 | $1,862.09 | $2,187.76 |
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 $707.95 Median $1,230.27 Typical High $2,691.53 | Professional | None | $707.95 | $1,230.27 | $2,691.53 |
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 $457.09 Median $478.63 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $199.53 | Professional | 53 · Discontinued | $181.97 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $676.08 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $100.00 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $691.83 |
Where Washington, DC sits
The same service costs 7.2 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· 33rd of 51
$1,096
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.