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 $1,698.24 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,445.44 | $1,548.82 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,479.11 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $3,801.89 | Professional | None | $1,122.02 | $1,318.26 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,884.03 | $3,311.31 |
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 $1,862.09 Typical High $3,981.07 | Professional | None | $1,000.00 | $1,862.09 | $3,981.07 |
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 $630.96 Median $724.44 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,096.48 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,023.29 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,023.29 | $1,096.48 |
Where Washington, DC sits
The same service costs 5.9 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· 40th of 51
$1,479
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.