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 $1,995.26 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,995.26 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,995.26 Typical High $4,897.79 | Professional | None | $1,905.46 | $1,995.26 | $4,897.79 |
CareFirst Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,995.26 | $2,238.72 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $5,248.07 | Professional | None | $1,698.24 | $1,819.70 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $3,981.07 Typical High $4,570.88 | Professional | None | $1,905.46 | $3,981.07 | $4,570.88 |
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 $1,479.11 Median $2,630.27 Typical High $5,495.41 | Professional | None | $1,479.11 | $2,630.27 | $5,495.41 |
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 $954.99 Median $1,000.00 Typical High $1,096.48 | Professional | 52 · Reduced service | $954.99 | $1,000.00 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $398.11 Typical High $436.52 | Professional | 53 · Discontinued | $380.19 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,479.11 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,412.54 | $1,479.11 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $295.12 Typical High $323.59 | Professional | 55 · Aftercare only | $288.40 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $199.53 Typical High $218.78 | Professional | 56 · Pre-op care only | $190.55 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,380.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,380.38 | $1,513.56 |
Where Washington, DC sits
The same service costs 21.4 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· 38th of 51
$2,138
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.