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 $691.83 Median $4,073.80 Typical High $7,079.46 | Facility | None | $691.83 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $691.83 | Professional | None | $630.96 | $691.83 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $758.58 | Professional | None | $537.03 | $588.84 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $1,071.52 | Professional | None | $537.03 | $630.96 | $1,071.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,348.96 | Professional | None | $562.34 | $616.60 | $1,348.96 |
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 $416.87 Median $524.81 Typical High $1,513.56 | Professional | None | $416.87 | $524.81 | $1,513.56 |
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 $316.23 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $436.52 | $489.78 | $489.78 |
Where Washington, DC sits
The same service costs 5.5 times more in Alaska than in Texas. 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
$617
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.