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 $812.83 Median $3,090.30 Typical High $6,606.93 | Facility | None | $812.83 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,122.02 | Professional | None | $724.44 | $812.83 | $1,122.02 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $4,570.88 | Professional | None | $562.34 | $645.65 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $2,290.87 | Professional | None | $645.65 | $912.01 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $2,187.76 | Professional | None | $891.25 | $954.99 | $2,187.76 |
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 $645.65 Median $1,230.27 Typical High $2,630.27 | Professional | None | $645.65 | $1,230.27 | $2,630.27 |
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 $363.08 Median $398.11 Typical High $562.34 | Professional | 52 · Reduced service | $363.08 | $398.11 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $223.87 | Professional | 53 · Discontinued | $144.54 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $851.14 | Professional | 54 · Surgery only | $537.03 | $602.56 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $169.82 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $112.20 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $794.33 |
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· 32nd of 51
$977
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.