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 $524.81 Median $2,818.38 Typical High $4,786.30 | Facility | None | $524.81 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $1,318.26 | Professional | None | $489.78 | $549.54 | $1,318.26 |
CareFirst Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $2,089.30 | Professional | None | $501.19 | $562.34 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,584.89 | Professional | None | $467.74 | $562.34 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $1,318.26 | Professional | None | $645.65 | $1,202.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $416.87 Median $724.44 Typical High $1,445.44 | Professional | None | $416.87 | $724.44 | $1,445.44 |
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 $251.19 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $371.54 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $407.38 |
Where Washington, DC sits
The same service costs 5.6 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· 36th of 51
$589
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.