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 $1,148.15 Median $4,073.80 Typical High $8,511.38 | Facility | None | $1,148.15 | $4,073.80 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,148.15 | $2,754.23 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $1,202.26 Typical High $1,445.44 | Professional | None | $630.96 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $3,162.28 | Professional | None | $1,071.52 | $1,122.02 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,071.52 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,071.52 | $2,290.87 | $2,630.27 |
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 $891.25 Median $1,621.81 Typical High $3,162.28 | Professional | None | $891.25 | $1,621.81 | $3,162.28 |
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 $537.03 Median $575.44 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $229.09 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $851.14 |
Where Washington, DC sits
The same service costs 8.1 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· 39th of 51
$1,202
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.