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 $1,258.93 Median $3,981.07 Typical High $7,413.10 | Facility | None | $1,258.93 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,258.93 | $3,235.94 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $7,244.36 | Professional | None | $1,202.26 | $1,348.96 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $3,311.31 | Professional | None | $1,071.52 | $1,148.15 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,258.93 | $2,454.71 | $2,884.03 |
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 $912.01 Median $1,621.81 Typical High $3,388.44 | Professional | None | $912.01 | $1,621.81 | $3,388.44 |
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 $588.84 Median $630.96 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $234.42 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $933.25 |
Where Washington, DC sits
The same service costs 6.8 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· 38th of 51
$1,349
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.