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 $1,412.54 Median $2,951.21 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,951.21 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,754.23 | $2,951.21 | $2,951.21 |
CareFirst Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,511.89 | $2,754.23 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $4,897.79 | Professional | None | $2,454.71 | $2,630.27 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $5,248.07 | Professional | None | $2,187.76 | $2,398.83 | $5,248.07 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,412.54 Typical High $6,309.57 | Facility | None | $426.58 | $1,412.54 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $6,456.54 | Professional | None | $1,995.26 | $2,398.83 | $6,456.54 |
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 $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $549.54 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,041.74 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,041.74 | $2,041.74 |
Where Washington, DC sits
The same service costs 20.4 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· 34th of 51
$2,754
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.