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 $316.23 Median $3,090.30 Typical High $6,606.93 | Facility | None | $316.23 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $954.99 | Professional | None | $316.23 | $467.74 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $2,344.23 | Professional | None | $309.03 | $346.74 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $1,348.96 | Professional | None | $288.40 | $467.74 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,122.02 | Professional | None | $512.86 | $741.31 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $1,202.26 | Professional | None | $281.84 | $537.03 | $1,202.26 |
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 $158.49 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $158.49 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $63.10 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $239.88 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $31.62 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $346.74 |
Where Washington, DC sits
The same service costs 5.2 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· 32nd of 51
$468
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.