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 $616.60 Median $3,388.44 Typical High $7,079.46 | Facility | None | $616.60 | $3,388.44 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,513.56 | Professional | None | $562.34 | $616.60 | $1,513.56 |
CareFirst Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $4,570.88 | Professional | None | $575.44 | $660.69 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $1,698.24 | Professional | None | $537.03 | $602.56 | $1,698.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $1,174.90 Typical High $1,380.38 | Professional | None | $588.84 | $1,174.90 | $1,380.38 |
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 $436.52 Median $776.25 Typical High $1,698.24 | Professional | None | $436.52 | $776.25 | $1,698.24 |
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 $275.42 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $436.52 |
Where Washington, DC sits
The same service costs 7.2 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
$661
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.