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 $257.04 Median $3,090.30 Typical High $6,606.93 | Facility | None | $257.04 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $416.87 | Professional | None | $239.88 | $257.04 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $3,235.94 | Professional | None | $199.53 | $218.78 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $831.76 | Professional | None | $186.21 | $295.12 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $758.58 | Professional | None | $346.74 | $478.63 | $758.58 |
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 $186.21 Median $295.12 Typical High $812.83 | Professional | None | $186.21 | $295.12 | $812.83 |
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 $120.23 Median $128.82 Typical High $208.93 | Professional | 52 · Reduced service | $120.23 | $128.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $51.29 Typical High $83.18 | Professional | 53 · Discontinued | $47.86 | $51.29 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $190.55 Typical High $316.23 | Professional | 54 · Surgery only | $177.83 | $190.55 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $63.10 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $25.70 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.99 | $25.70 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $177.83 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $165.96 | $177.83 | $295.12 |
Where Washington, DC sits
The same service costs 4.3 times more in Wyoming 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
$288
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.