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 $1,023.29 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,023.29 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,023.29 | Professional | None | $891.25 | $1,023.29 | $1,023.29 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $5,011.87 | Professional | None | $977.24 | $1,071.52 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $2,818.38 | Professional | None | $912.01 | $1,000.00 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,995.26 Typical High $2,290.87 | Professional | None | $933.25 | $1,995.26 | $2,290.87 |
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 $758.58 Median $1,412.54 Typical High $2,818.38 | Professional | None | $758.58 | $1,412.54 | $2,818.38 |
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 $467.74 Median $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $794.33 | Professional | 54 · Surgery only | $707.95 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $741.31 |
Where Washington, DC sits
The same service costs 8.3 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
$1,072
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.