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 $93.33 Median $1,548.82 Typical High $3,311.31 | Facility | None | $93.33 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $281.84 | Professional | None | $93.33 | $151.36 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $645.65 | Professional | None | $79.43 | $87.10 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $275.42 | Professional | None | $107.15 | $169.82 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $389.05 | Professional | None | $165.96 | $239.88 | $389.05 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $398.11 | Professional | None | $95.50 | $158.49 | $398.11 |
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 $46.77 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $46.77 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.91 Typical High $30.20 | Professional | 53 · Discontinued | $18.62 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $69.18 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.48 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.33 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $79.43 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $64.57 | $79.43 | $107.15 |
Where Washington, DC sits
The same service costs 3.2 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· 44th of 51
$151
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.