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 $151.36 Median $1,548.82 Typical High $3,311.31 | Facility | None | $151.36 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $234.42 | Professional | None | $151.36 | $208.93 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $2,089.30 | Professional | None | $131.83 | $144.54 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $575.44 | Professional | None | $141.25 | $208.93 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $229.09 Typical High $457.09 | Professional | None | $218.78 | $229.09 | $457.09 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $549.54 | Professional | None | $123.03 | $251.19 | $549.54 |
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 $75.86 Median $77.62 Typical High $117.49 | Professional | 52 · Reduced service | $75.86 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.90 Typical High $46.77 | Professional | 53 · Discontinued | $30.20 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $114.82 Typical High $173.78 | Professional | 54 · Surgery only | $114.82 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $34.67 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.49 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.14 | $15.49 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $107.15 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $107.15 | $107.15 | $162.18 |
Where Washington, DC sits
The same service costs 4.1 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· 29th of 51
$229
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.