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 $131.83 Median $1,737.80 Typical High $4,786.30 | Facility | None | $131.83 | $1,737.80 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $331.13 Typical High $1,047.13 | Professional | None | $131.83 | $331.13 | $1,047.13 |
CareFirst Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $1,380.38 | Professional | None | $125.89 | $141.25 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $363.08 Typical High $891.25 | Professional | None | $134.90 | $363.08 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,513.56 | Professional | None | $660.69 | $776.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $125.89 Median $380.19 Typical High $1,584.89 | Professional | None | $125.89 | $380.19 | $1,584.89 |
5 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 $66.07 Median $75.86 Typical High $346.74 | Professional | 52 · Reduced service | $66.07 | $75.86 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $30.20 Typical High $138.04 | Professional | 53 · Discontinued | $26.30 | $30.20 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $112.20 Typical High $524.81 | Professional | 54 · Surgery only | $97.72 | $112.20 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $22.39 Typical High $104.71 | Professional | 55 · Aftercare only | $19.50 | $22.39 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.14 Typical High $69.18 | Professional | 56 · Pre-op care only | $13.18 | $15.14 | $69.18 |
Where Washington, DC sits
The same service costs 3.7 times more in Wisconsin than in Nebraska. 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· 49th of 51
$331
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.