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 $1,000.00 Median $1,698.24 Typical High $7,943.28 | Facility | None | $1,000.00 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | None | $912.01 | $1,000.00 | $1,000.00 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $954.99 | Professional | None | $831.76 | $933.25 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,584.89 | Professional | None | $812.83 | $891.25 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,949.84 | Professional | None | $758.58 | $851.14 | $1,949.84 |
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 $645.65 Median $794.33 Typical High $2,187.76 | Professional | None | $645.65 | $794.33 | $2,187.76 |
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 $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $457.09 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $181.97 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $691.83 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $91.20 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $691.83 |
Where Washington, DC sits
The same service costs 4.7 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
$933
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.