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 $181.97 Median $1,548.82 Typical High $3,311.31 | Facility | None | $181.97 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $457.09 | Professional | None | $177.83 | $229.09 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $2,089.30 | Professional | None | $173.78 | $194.98 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $489.78 | Professional | None | $173.78 | $223.87 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $549.54 | Professional | None | $245.47 | $426.58 | $549.54 |
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 $147.91 Median $229.09 Typical High $489.78 | Professional | None | $147.91 | $229.09 | $489.78 |
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 $89.13 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $36.31 Typical High $47.86 | Professional | 53 · Discontinued | $35.48 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $134.90 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $128.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $125.89 | $128.82 | $165.96 |
Where Washington, DC sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 36th of 51
$224
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.