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 $2,398.83 Typical High $7,943.28 | Facility | None | $1,412.54 | $2,398.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,238.72 | $2,398.83 | $2,398.83 |
CareFirst Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,691.53 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $6,309.57 | Professional | None | $2,089.30 | $2,187.76 | $6,309.57 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,344.23 Median $4,786.30 Typical High $5,495.41 | Professional | None | $2,344.23 | $4,786.30 | $5,495.41 |
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 $1,819.70 Median $3,162.28 Typical High $6,606.93 | Professional | None | $1,819.70 | $3,162.28 | $6,606.93 |
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 $1,148.15 Median $1,202.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $478.63 Typical High $524.81 | Professional | 53 · Discontinued | $457.09 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,819.70 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,698.24 | $1,819.70 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $363.08 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $263.03 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,698.24 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,698.24 | $1,819.70 |
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· 38th of 51
$2,455
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.