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 $489.78 Median $4,073.80 Typical High $7,413.10 | Facility | None | $489.78 | $4,073.80 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $5,128.61 Typical High $10,715.19 | Professional | None | $478.63 | $5,128.61 | $10,715.19 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $11,220.18 | Professional | None | $457.09 | $512.86 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,318.26 Typical High $15,848.93 | Professional | None | $457.09 | $1,318.26 | $15,848.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $6,760.83 Typical High $14,791.08 | Professional | None | $1,096.48 | $6,760.83 | $14,791.08 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $446.68 Median $1,348.96 Typical High $15,135.61 | Professional | None | $446.68 | $1,348.96 | $15,135.61 |
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 $245.47 Median $2,570.40 Typical High $3,162.28 | Professional | 52 · Reduced service | $245.47 | $2,570.40 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $1,023.29 Typical High $1,258.93 | Professional | 53 · Discontinued | $97.72 | $1,023.29 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $3,890.45 Typical High $4,786.30 | Professional | 54 · Surgery only | $363.08 | $3,890.45 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $776.25 Typical High $954.99 | Professional | 55 · Aftercare only | $72.44 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $512.86 Typical High $630.96 | Professional | 56 · Pre-op care only | $48.98 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $3,630.78 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $338.84 | $3,630.78 | $4,466.84 |
Where Washington, DC sits
The same service costs 13.5 times more in Oregon 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· 37th of 51
$1,318
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.