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 $436.52 Median $616.60 Typical High $1,230.27 | Professional | None | $436.52 | $616.60 | $1,230.27 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $2,630.27 | Professional | None | $426.58 | $478.63 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,659.59 | Professional | None | $398.11 | $588.84 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,412.54 | Professional | None | $630.96 | $1,023.29 | $1,412.54 |
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 $380.19 Median $691.83 Typical High $1,513.56 | Professional | None | $380.19 | $691.83 | $1,513.56 |
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 $218.78 Median $269.15 Typical High $309.03 | Professional | 52 · Reduced service | $218.78 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $107.15 Typical High $123.03 | Professional | 53 · Discontinued | $87.10 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $331.13 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $309.03 | $371.54 | $426.58 |
Where Washington, DC sits
The same service costs 5.5 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
$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.