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 $1,819.70 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,819.70 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,778.28 | $1,819.70 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,698.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,621.81 | $2,951.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $3,548.13 | Professional | None | $1,348.96 | $1,513.56 | $3,548.13 |
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 $1,202.26 Median $1,479.11 Typical High $3,981.07 | Professional | None | $1,202.26 | $1,479.11 | $3,981.07 |
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 $831.76 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,258.93 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $165.96 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,258.93 | $1,258.93 |
Where Washington, DC sits
The same service costs 21.9 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
$1,698
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.