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 $3,388.44 Typical High $6,606.93 | Facility | None | $1,148.15 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,148.15 | $2,884.03 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $7,244.36 | Professional | None | $1,148.15 | $1,288.25 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,071.52 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $2,398.83 Typical High $2,630.27 | Professional | None | $1,122.02 | $2,398.83 | $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 $912.01 Median $1,584.89 Typical High $3,090.30 | Professional | None | $912.01 | $1,584.89 | $3,090.30 |
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 $549.54 Median $575.44 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $575.44 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $977.24 | Professional | 54 · Surgery only | $831.76 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $194.98 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $114.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $912.01 |
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· 39th of 51
$1,288
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.