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 $56.23 Median $1,548.82 Typical High $3,311.31 | Facility | None | $56.23 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $138.04 Typical High $275.42 | Professional | None | $54.95 | $138.04 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $645.65 | Professional | None | $56.23 | $61.66 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $147.91 Typical High $186.21 | Professional | None | $52.48 | $147.91 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $380.19 | Professional | None | $128.82 | $186.21 | $380.19 |
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 $54.95 Median $134.90 Typical High $338.84 | Professional | None | $54.95 | $134.90 | $338.84 |
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 $27.54 Median $28.18 Typical High $83.18 | Professional | 52 · Reduced service | $27.54 | $28.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $33.11 | Professional | 53 · Discontinued | $10.96 | $11.22 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $123.03 | Professional | 54 · Surgery only | $41.69 | $41.69 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $24.55 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $16.60 |
Where Washington, DC sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 43rd of 51
$132
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.