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 $162.18 Median $1,548.82 Typical High $3,311.31 | Facility | None | $162.18 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $389.05 | Professional | None | $158.49 | $275.42 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $165.96 | Professional | None | $131.83 | $144.54 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $275.42 Typical High $380.19 | Professional | None | $141.25 | $275.42 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $741.31 | Professional | None | $338.84 | $380.19 | $741.31 |
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 $112.20 Median $218.78 Typical High $446.68 | Professional | None | $112.20 | $218.78 | $446.68 |
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 $77.62 Median $109.65 Typical High $194.98 | Professional | 52 · Reduced service | $77.62 | $109.65 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $44.67 Typical High $77.62 | Professional | 53 · Discontinued | $31.62 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $165.96 Typical High $288.40 | Professional | 54 · Surgery only | $117.49 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.11 Typical High $57.54 | Professional | 55 · Aftercare only | $23.44 | $33.11 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.39 Typical High $38.90 | Professional | 56 · Pre-op care only | $15.85 | $22.39 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $154.88 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $109.65 | $154.88 | $269.15 |
Where Washington, DC sits
The same service costs 3.6 times more in Alaska than in Washington, DC. 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· 51st of 51
$162
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.