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 $724.44 Median $2,137.96 Typical High $6,606.93 | Facility | None | $724.44 | $2,137.96 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,819.70 | Professional | None | $691.83 | $724.44 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $4,073.80 | Professional | None | $691.83 | $776.25 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,995.26 | Professional | None | $660.69 | $707.95 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,445.44 Typical High $1,659.59 | Professional | None | $676.08 | $1,445.44 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $537.03 Median $977.24 Typical High $1,995.26 | Professional | None | $537.03 | $977.24 | $1,995.26 |
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 $338.84 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $338.84 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $134.90 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $100.00 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $524.81 |
Where Washington, DC sits
The same service costs 7.6 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· 38th of 51
$776
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.