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 $3,548.13 Typical High $4,786.30 | Facility | None | $489.78 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | None | $478.63 | $489.78 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $489.78 | Professional | None | $380.19 | $426.58 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $851.14 | Professional | None | $407.38 | $426.58 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $933.25 | Professional | None | $363.08 | $407.38 | $933.25 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $1,047.13 | Professional | None | $338.84 | $407.38 | $1,047.13 |
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 $223.87 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $316.23 | $338.84 | $338.84 |
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· 44th of 51
$427
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.