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 $660.69 Median $2,818.38 Typical High $4,786.30 | Facility | None | $660.69 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $1,659.59 | Professional | None | $630.96 | $660.69 | $1,659.59 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $6,309.57 | Professional | None | $630.96 | $707.95 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $1,819.70 | Professional | None | $602.56 | $660.69 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $1,288.25 Typical High $1,513.56 | Professional | None | $630.96 | $1,288.25 | $1,513.56 |
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 $512.86 Median $933.25 Typical High $1,819.70 | Professional | None | $512.86 | $933.25 | $1,819.70 |
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 $316.23 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $138.04 | Professional | 53 · Discontinued | $125.89 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $489.78 |
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· 39th of 51
$708
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.