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 $851.14 Median $4,073.80 Typical High $7,079.46 | Facility | None | $851.14 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $2,041.74 | Professional | None | $794.33 | $851.14 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $4,570.88 | Professional | None | $724.44 | $912.01 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $2,344.23 | Professional | None | $758.58 | $831.76 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $1,659.59 Typical High $1,949.84 | Professional | None | $812.83 | $1,659.59 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $2,344.23 | Professional | None | $616.60 | $1,122.02 | $2,344.23 |
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 $398.11 Median $426.58 Typical High $436.52 | Professional | 52 · Reduced service | $398.11 | $426.58 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $173.78 | Professional | 53 · Discontinued | $158.49 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $588.84 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $131.83 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $87.10 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $616.60 |
Where Washington, DC sits
The same service costs 7.4 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
$912
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.