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 $281.84 Median $1,698.24 Typical High $4,073.80 | Facility | None | $281.84 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $371.54 | Professional | None | $245.47 | $281.84 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $645.65 | Professional | None | $288.40 | $323.59 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $812.83 | Professional | None | $245.47 | $288.40 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $676.08 | Professional | None | $338.84 | $645.65 | $676.08 |
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 $204.17 Median $363.08 Typical High $794.33 | Professional | None | $204.17 | $363.08 | $794.33 |
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 $128.82 Median $141.25 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $194.98 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $208.93 |
Where Washington, DC sits
The same service costs 5.9 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· 35th of 51
$295
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.