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 $3,388.44 Typical High $6,606.93 | Facility | None | $1,412.54 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $3,467.37 | Professional | None | $1,348.96 | $1,412.54 | $3,467.37 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $12,302.69 | Professional | None | $1,380.38 | $1,548.82 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,288.25 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $3,235.94 | Professional | None | $1,288.25 | $2,818.38 | $3,235.94 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,071.52 | $1,862.09 | $3,801.89 |
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 $676.08 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $676.08 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $1,071.52 |
Where Washington, DC sits
The same service costs 7.2 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
$1,549
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.