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 $537.03 Median $3,548.13 Typical High $4,786.30 | Facility | None | $537.03 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | None | $489.78 | $537.03 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $549.54 | Professional | None | $426.58 | $478.63 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $870.96 | Professional | None | $436.52 | $478.63 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $1,047.13 | Professional | None | $407.38 | $457.09 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $1,174.90 | Professional | None | $354.81 | $436.52 | $1,174.90 |
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 $245.47 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $371.54 |
Where Washington, DC sits
The same service costs 5.4 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· 41st of 51
$479
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.