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 $30.20 Median $1,548.82 Typical High $3,311.31 | Facility | None | $30.20 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $72.44 Typical High $120.23 | Professional | None | $30.20 | $72.44 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $30.20 Median $33.88 Typical High $549.54 | Professional | None | $30.20 | $33.88 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $67.61 Typical High $102.33 | Professional | None | $28.18 | $67.61 | $102.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $173.78 | Professional | None | $70.79 | $87.10 | $173.78 |
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 $29.51 Median $69.18 Typical High $162.18 | Professional | None | $29.51 | $69.18 | $162.18 |
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 $15.14 Median $15.14 Typical High $38.02 | Professional | 52 · Reduced service | $15.14 | $15.14 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $15.14 | Professional | 53 · Discontinued | $6.03 | $6.03 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $22.91 Typical High $56.23 | Professional | 54 · Surgery only | $22.91 | $22.91 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $11.22 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $7.59 |
Where Washington, DC sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 35th of 51
$66.07
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.