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 $138.04 Median $1,698.24 Typical High $4,073.80 | Facility | None | $138.04 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $223.87 | Professional | None | $134.90 | $173.78 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $645.65 | Professional | None | $138.04 | $151.36 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $194.98 Typical High $371.54 | Professional | None | $128.82 | $194.98 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $478.63 | Professional | None | $213.80 | $245.47 | $478.63 |
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 $120.23 Median $194.98 Typical High $446.68 | Professional | None | $120.23 | $194.98 | $446.68 |
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 $67.61 Median $69.18 Typical High $107.15 | Professional | 52 · Reduced service | $67.61 | $69.18 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $27.54 Typical High $42.66 | Professional | 53 · Discontinued | $26.92 | $27.54 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $102.33 Typical High $158.49 | Professional | 54 · Surgery only | $100.00 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.80 Typical High $21.38 | Professional | 56 · Pre-op care only | $13.49 | $13.80 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $95.50 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $93.33 | $95.50 | $147.91 |
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· 41st of 51
$182
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.