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 $144.54 Median $2,818.38 Typical High $4,786.30 | Facility | None | $144.54 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $144.54 Typical High $239.88 | Professional | None | $141.25 | $144.54 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $2,089.30 | Professional | None | $117.49 | $144.54 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $223.87 Typical High $575.44 | Professional | None | $138.04 | $223.87 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $512.86 | Professional | None | $229.09 | $316.23 | $512.86 |
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 $120.23 Median $275.42 Typical High $575.44 | Professional | None | $120.23 | $275.42 | $575.44 |
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 $70.79 Median $72.44 Typical High $120.23 | Professional | 52 · Reduced service | $70.79 | $72.44 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $29.51 Typical High $48.98 | Professional | 53 · Discontinued | $28.18 | $29.51 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $109.65 Typical High $181.97 | Professional | 54 · Surgery only | $104.71 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $21.88 Typical High $36.31 | Professional | 55 · Aftercare only | $20.89 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.45 Typical High $23.99 | Professional | 56 · Pre-op care only | $14.13 | $14.45 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $102.33 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $97.72 | $102.33 | $169.82 |
Where Washington, DC sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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· 23rd of 51
$234
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.