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 $245.47 Median $1,698.24 Typical High $4,073.80 | Facility | None | $245.47 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $323.59 | Professional | None | $245.47 | $251.19 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $2,570.40 | Professional | None | $208.93 | $229.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $794.33 | Professional | None | $223.87 | $309.03 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $645.65 | Professional | None | $302.00 | $323.59 | $645.65 |
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 $199.53 Median $354.81 Typical High $776.25 | Professional | None | $199.53 | $354.81 | $776.25 |
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 $123.03 Median $125.89 Typical High $162.18 | Professional | 52 · Reduced service | $123.03 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $64.57 | Professional | 53 · Discontinued | $48.98 | $50.12 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $181.97 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $38.02 Typical High $48.98 | Professional | 55 · Aftercare only | $36.31 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $32.36 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $169.82 | $173.78 | $229.09 |
Where Washington, DC sits
The same service costs 4.5 times more in Oklahoma 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
$309
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.