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 $338.84 Median $3,090.30 Typical High $6,606.93 | Facility | None | $338.84 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $831.76 | Professional | None | $323.59 | $478.63 | $831.76 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $4,073.80 | Professional | None | $323.59 | $354.81 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $478.63 Typical High $1,380.38 | Professional | None | $288.40 | $478.63 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,174.90 | Professional | None | $537.03 | $758.58 | $1,174.90 |
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 $549.54 Typical High $1,258.93 | Professional | None | $281.84 | $549.54 | $1,258.93 |
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 $162.18 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $85.11 Typical High $102.33 | Professional | 53 · Discontinued | $66.07 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $323.59 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $42.66 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $302.00 | $363.08 |
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· 31st of 51
$479
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.