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 $112.20 Median $1,698.24 Typical High $4,786.30 | Facility | None | $112.20 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $165.96 Typical High $288.40 | Professional | None | $109.65 | $165.96 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $1,584.89 | Professional | None | $104.71 | $117.49 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $295.12 | Professional | None | $104.71 | $154.88 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $389.05 | Professional | None | $169.82 | $257.04 | $389.05 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $346.74 | Professional | None | $93.33 | $151.36 | $346.74 |
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 $54.95 Median $56.23 Typical High $83.18 | Professional | 52 · Reduced service | $54.95 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $33.11 | Professional | 53 · Discontinued | $21.88 | $22.39 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $83.18 Typical High $125.89 | Professional | 54 · Surgery only | $81.28 | $83.18 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $25.12 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $77.62 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $75.86 | $77.62 | $117.49 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 30th of 51
$155
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.