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 $123.03 Median $1,698.24 Typical High $4,073.80 | Facility | None | $123.03 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $354.81 | Professional | None | $123.03 | $144.54 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $645.65 | Professional | None | $123.03 | $134.90 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $380.19 | Professional | None | $112.20 | $158.49 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $288.40 Typical High $331.13 | Professional | None | $151.36 | $288.40 | $331.13 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $354.81 | Professional | None | $112.20 | $177.83 | $354.81 |
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 $61.66 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $61.66 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $28.84 | Professional | 53 · Discontinued | $24.55 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $93.33 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $87.10 | $93.33 | $100.00 |
Where Washington, DC sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 37th of 51
$151
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.