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 $436.52 Median $1,548.82 Typical High $3,311.31 | Facility | None | $436.52 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $1,047.13 | Professional | None | $416.87 | $457.09 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $1,380.38 | Professional | None | $380.19 | $467.74 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $1,318.26 | Professional | None | $380.19 | $467.74 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,122.02 | Professional | None | $575.44 | $1,000.00 | $1,122.02 |
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 $331.13 Median $588.84 Typical High $1,230.27 | Professional | None | $331.13 | $588.84 | $1,230.27 |
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 $204.17 Median $218.78 Typical High $245.47 | Professional | 52 · Reduced service | $204.17 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $363.08 | Professional | 54 · Surgery only | $309.03 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $72.44 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $338.84 |
Where Washington, DC sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 34th of 51
$490
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.