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 $478.63 Median $2,137.96 Typical High $6,606.93 | Facility | None | $478.63 | $2,137.96 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $1,174.90 | Professional | None | $446.68 | $478.63 | $1,174.90 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $2,630.27 | Professional | None | $457.09 | $512.86 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $1,318.26 | Professional | None | $426.58 | $467.74 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $933.25 Typical High $1,096.48 | Professional | None | $457.09 | $933.25 | $1,096.48 |
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 $363.08 Median $660.69 Typical High $1,318.26 | Professional | None | $363.08 | $660.69 | $1,318.26 |
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 $223.87 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $89.13 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $338.84 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $67.61 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $44.67 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $316.23 | $331.13 | $346.74 |
Where Washington, DC sits
The same service costs 6.2 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· 39th of 51
$513
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.