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 $1,380.38 Median $1,513.56 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,513.56 | $1,621.81 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,584.89 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $3,981.07 | Professional | None | $1,288.25 | $1,380.38 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,513.56 Median $3,019.95 Typical High $3,467.37 | Professional | None | $1,513.56 | $3,019.95 | $3,467.37 |
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 $1,122.02 Median $1,905.46 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,905.46 | $4,073.80 |
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 $691.83 Median $758.58 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $758.58 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | 53 · Discontinued | $275.42 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $162.18 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,047.13 | $1,122.02 |
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· 38th 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.