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 $331.13 Median $1,698.24 Typical High $4,073.80 | Facility | None | $331.13 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $371.54 | Professional | None | $309.03 | $331.13 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $630.96 | Professional | None | $302.00 | $354.81 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $1,023.29 | Professional | None | $275.42 | $363.08 | $1,023.29 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $851.14 | Professional | None | $416.87 | $758.58 | $851.14 |
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 $213.80 Median $436.52 Typical High $933.25 | Professional | None | $213.80 | $436.52 | $933.25 |
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 $154.88 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $154.88 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $61.66 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $234.42 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $50.12 Typical High $56.23 | Professional | 55 · Aftercare only | $46.77 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $218.78 | $234.42 | $263.03 |
Where Washington, DC sits
The same service costs 5.4 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
$363
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.