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 $602.56 Median $3,388.44 Typical High $6,606.93 | Facility | None | $602.56 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | None | $562.34 | $602.56 | $602.56 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $616.60 | Professional | None | $478.63 | $524.81 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $977.24 | Professional | None | $501.19 | $537.03 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $1,047.13 | Professional | None | $416.87 | $467.74 | $1,047.13 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $1,318.26 | Professional | None | $407.38 | $478.63 | $1,318.26 |
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 $281.84 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $281.84 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $85.11 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $416.87 |
Where Washington, DC sits
The same service costs 5.9 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· 42nd of 51
$525
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.