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 $295.12 Median $2,818.38 Typical High $4,786.30 | Facility | None | $295.12 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $1,288.25 | Professional | None | $295.12 | $512.86 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $1,584.89 | Professional | None | $275.42 | $309.03 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $794.33 | Professional | None | $281.84 | $478.63 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,202.26 | Professional | None | $575.44 | $691.83 | $1,202.26 |
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 $275.42 Median $512.86 Typical High $1,202.26 | Professional | None | $275.42 | $512.86 | $1,202.26 |
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 $147.91 Median $147.91 Typical High $257.04 | Professional | 52 · Reduced service | $147.91 | $147.91 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $104.71 | Professional | 53 · Discontinued | $58.88 | $58.88 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $389.05 | Professional | 54 · Surgery only | $218.78 | $223.87 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $77.62 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $51.29 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $51.29 |
Where Washington, DC sits
The same service costs 3.0 times more in Alaska than in Maryland. 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· 40th of 51
$479
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.