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 $239.88 Median $1,698.24 Typical High $4,786.30 | Facility | None | $239.88 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $977.24 | Professional | None | $239.88 | $398.11 | $977.24 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $741.31 | Professional | None | $204.17 | $223.87 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $645.65 | Professional | None | $251.19 | $389.05 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $933.25 | Professional | None | $407.38 | $562.34 | $933.25 |
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 $229.09 Median $371.54 Typical High $851.14 | Professional | None | $229.09 | $371.54 | $851.14 |
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 $120.23 Median $120.23 Typical High $204.17 | Professional | 52 · Reduced service | $120.23 | $120.23 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $81.28 | Professional | 53 · Discontinued | $47.86 | $47.86 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $181.97 Typical High $302.00 | Professional | 54 · Surgery only | $177.83 | $181.97 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $36.31 Typical High $60.26 | Professional | 55 · Aftercare only | $35.48 | $36.31 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $40.74 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $169.82 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $165.96 | $169.82 | $281.84 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 31st of 51
$363
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.