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 $426.58 Median $3,090.30 Typical High $6,606.93 | Facility | None | $426.58 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $1,995.26 | Professional | None | $426.58 | $426.58 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $2,951.21 | Professional | None | $323.59 | $363.08 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $912.01 Typical High $3,890.45 | Professional | None | $346.74 | $912.01 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $3,019.95 Typical High $3,548.13 | Professional | None | $776.25 | $3,019.95 | $3,548.13 |
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 $316.23 Median $1,047.13 Typical High $4,365.16 | Professional | None | $316.23 | $1,047.13 | $4,365.16 |
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 $208.93 Median $208.93 Typical High $1,000.00 | Professional | 52 · Reduced service | $208.93 | $208.93 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $398.11 | Professional | 53 · Discontinued | $85.11 | $85.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,479.11 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $295.12 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $199.53 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $1,380.38 |
Where Washington, DC sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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
$1,413
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.