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 $3,090.30 Typical High $6,606.93 | Facility | None | $436.52 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $1,096.48 | Professional | None | $416.87 | $436.52 | $1,096.48 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $4,073.80 | Professional | None | $426.58 | $478.63 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $1,230.27 | Professional | None | $407.38 | $436.52 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $870.96 Typical High $1,000.00 | Professional | None | $436.52 | $870.96 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $338.84 Median $616.60 Typical High $1,230.27 | Professional | None | $338.84 | $616.60 | $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 $208.93 Median $218.78 Typical High $223.87 | Professional | 52 · Reduced service | $208.93 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $338.84 | Professional | 54 · Surgery only | $309.03 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $66.07 Typical High $67.61 | Professional | 55 · Aftercare only | $63.10 | $66.07 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $316.23 |
Where Washington, DC sits
The same service costs 6.0 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· 40th of 51
$479
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.