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 $489.78 Median $3,388.44 Typical High $6,606.93 | Facility | None | $489.78 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | None | $467.74 | $489.78 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $616.60 | Professional | None | $407.38 | $457.09 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $446.68 Typical High $812.83 | Professional | None | $389.05 | $446.68 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $954.99 | Professional | None | $398.11 | $446.68 | $954.99 |
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 $316.23 Median $407.38 Typical High $1,071.52 | Professional | None | $316.23 | $407.38 | $1,071.52 |
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 $234.42 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $234.42 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $323.59 | $346.74 | $346.74 |
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· 35th of 51
$457
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.