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 $128.82 Median $1,548.82 Typical High $3,311.31 | Facility | None | $128.82 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $323.59 | Professional | None | $117.49 | $131.83 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $645.65 | Professional | None | $125.89 | $147.91 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $363.08 | Professional | None | $114.82 | $125.89 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $302.00 | Professional | None | $141.25 | $295.12 | $302.00 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $91.20 Median $169.82 Typical High $363.08 | Professional | None | $91.20 | $169.82 | $363.08 |
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 $60.26 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.70 Typical High $26.30 | Professional | 53 · Discontinued | $23.99 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.02 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $83.18 | $91.20 | $91.20 |
Where Washington, DC sits
The same service costs 5.1 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· 28th of 51
$148
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.