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 $83.18 Median $1,698.24 Typical High $4,786.30 | Facility | None | $83.18 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $204.17 Typical High $741.31 | Professional | None | $83.18 | $204.17 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $630.96 | Professional | None | $79.43 | $87.10 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $229.09 Typical High $676.08 | Professional | None | $83.18 | $229.09 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $1,023.29 | Professional | None | $371.54 | $436.52 | $1,023.29 |
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 $77.62 Median $269.15 Typical High $912.01 | Professional | None | $77.62 | $269.15 | $912.01 |
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 $41.69 Median $41.69 Typical High $199.53 | Professional | 52 · Reduced service | $41.69 | $41.69 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $79.43 | Professional | 53 · Discontinued | $16.60 | $16.60 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $61.66 Typical High $295.12 | Professional | 54 · Surgery only | $61.66 | $61.66 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $58.88 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $37.15 Typical High $39.81 | Professional | 56 · Pre-op care only | $8.32 | $37.15 | $39.81 |
Where Washington, DC sits
The same service costs 6.8 times more in Wisconsin than in Hawaii. 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· 48th of 51
$209
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.