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 $1,778.28 Typical High $7,943.28 | Facility | None | $1,412.54 | $1,778.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,778.28 | $1,905.46 |
CareFirst Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,995.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $4,677.35 | Professional | None | $1,548.82 | $1,621.81 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $3,630.78 Typical High $4,073.80 | Professional | None | $1,778.28 | $3,630.78 | $4,073.80 |
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 $1,348.96 Median $2,290.87 Typical High $4,897.79 | Professional | None | $1,348.96 | $2,290.87 | $4,897.79 |
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 $851.14 Median $891.25 Typical High $954.99 | Professional | 52 · Reduced service | $851.14 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $288.40 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,258.93 | $1,348.96 |
Where Washington, DC sits
The same service costs 6.0 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· 37th of 51
$1,820
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.