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 $870.96 Median $3,548.13 Typical High $8,511.38 | Facility | None | $870.96 | $3,548.13 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $2,290.87 | Professional | None | $831.76 | $870.96 | $2,290.87 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $8,912.51 | Professional | None | $831.76 | $912.01 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $2,344.23 | Professional | None | $758.58 | $794.33 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,737.80 Typical High $1,995.26 | Professional | None | $891.25 | $1,737.80 | $1,995.26 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $13,182.57 Typical High $48,977.88 | Facility | None | $5,888.44 | $13,182.57 | $48,977.88 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,122.02 Typical High $2,398.83 | Professional | None | $676.08 | $1,122.02 | $2,398.83 |
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 $426.58 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $426.58 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $169.82 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $630.96 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $616.60 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $588.84 | $616.60 | $660.69 |
Where Washington, DC sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$933
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.