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 $275.42 Median $3,090.30 Typical High $6,606.93 | Facility | None | $275.42 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $426.58 | Professional | None | $269.15 | $363.08 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $2,344.23 | Professional | None | $263.03 | $295.12 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $1,148.15 | Professional | None | $251.19 | $398.11 | $1,148.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $630.96 Typical High $977.24 | Professional | None | $426.58 | $630.96 | $977.24 |
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 $239.88 Median $478.63 Typical High $1,047.13 | Professional | None | $239.88 | $478.63 | $1,047.13 |
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 $134.90 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $54.95 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $204.17 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $190.55 | $257.04 | $302.00 |
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· 33rd of 51
$398
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.