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 $338.84 Median $1,412.54 Typical High $7,943.28 | Facility | None | $338.84 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $933.25 | Professional | None | $323.59 | $371.54 | $933.25 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $645.65 | Professional | None | $251.19 | $380.19 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $1,000.00 | Professional | None | $281.84 | $354.81 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $776.25 Typical High $851.14 | Professional | None | $436.52 | $776.25 | $851.14 |
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 $234.42 Median $436.52 Typical High $954.99 | Professional | None | $234.42 | $436.52 | $954.99 |
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 $151.36 Median $169.82 Typical High $186.21 | Professional | 52 · Reduced service | $151.36 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $223.87 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $44.67 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.88 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $239.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $208.93 | $239.88 | $257.04 |
Where Washington, DC sits
The same service costs 5.0 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· 34th of 51
$372
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.