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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,258.93 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,230.27 | $1,258.93 | $1,412.54 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,513.56 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $3,388.44 | Professional | None | $1,148.15 | $1,174.90 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $2,951.21 | Professional | None | $1,174.90 | $2,570.40 | $2,951.21 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $3,467.37 | Professional | None | $1,000.00 | $1,659.59 | $3,467.37 |
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 $616.60 Median $630.96 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $630.96 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $977.24 |
Where Washington, DC sits
The same service costs 26.3 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· 35th of 51
$1,514
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.