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 $851.14 Median $4,073.80 Typical High $7,079.46 | Facility | None | $851.14 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | None | $812.83 | $851.14 | $851.14 |
CareFirst Setting Professional Modifier None Typical Low $676.08 Median $758.58 Typical High $870.96 | Professional | None | $676.08 | $758.58 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,380.38 | Professional | None | $691.83 | $758.58 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $1,659.59 | Professional | None | $645.65 | $724.44 | $1,659.59 |
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 $549.54 Median $691.83 Typical High $1,862.09 | Professional | None | $549.54 | $691.83 | $1,862.09 |
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 $389.05 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $588.84 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $588.84 |
Where Washington, DC sits
The same service costs 6.0 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
$759
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.