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 $26.30 Median $1,698.24 Typical High $4,073.80 | Facility | None | $26.30 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $57.54 Typical High $70.79 | Professional | None | $26.30 | $57.54 | $70.79 |
CareFirst Setting Professional Modifier None Typical Low $25.12 Median $28.18 Typical High $1,380.38 | Professional | None | $25.12 | $28.18 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $56.23 Typical High $72.44 | Professional | None | $24.55 | $56.23 | $72.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $141.25 | Professional | None | $63.10 | $72.44 | $141.25 |
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 $26.30 Median $53.70 Typical High $120.23 | Professional | None | $26.30 | $53.70 | $120.23 |
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 $13.18 Median $13.18 Typical High $30.20 | Professional | 52 · Reduced service | $13.18 | $13.18 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $12.02 | Professional | 53 · Discontinued | $5.25 | $5.25 | $12.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $19.50 Typical High $44.67 | Professional | 54 · Surgery only | $19.50 | $19.50 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $8.91 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $4.57 Typical High $6.03 | Professional | 56 · Pre-op care only | $2.63 | $4.57 | $6.03 |
Where Washington, DC sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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
$52.48
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.