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 $16.22 Median $1,412.54 Typical High $7,943.28 | Facility | None | $16.22 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $18.62 Typical High $40.74 | Professional | None | $16.22 | $18.62 | $40.74 |
CareFirst Setting Professional Modifier None Typical Low $15.85 Median $17.78 Typical High $549.54 | Professional | None | $15.85 | $17.78 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $17.38 Typical High $42.66 | Professional | None | $15.14 | $17.38 | $42.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $19.50 Median $37.15 Typical High $42.66 | Professional | None | $19.50 | $37.15 | $42.66 |
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 $13.18 Median $19.50 Typical High $42.66 | Professional | None | $13.18 | $19.50 | $42.66 |
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 $8.13 Median $8.13 Typical High $9.33 | Professional | 52 · Reduced service | $8.13 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.31 Typical High $3.72 | Professional | 53 · Discontinued | $3.24 | $3.31 | $3.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $12.30 Typical High $13.80 | Professional | 54 · Surgery only | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.82 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.86 |
Where Washington, DC sits
The same service costs 3.9 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· 43rd of 51
$18.20
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.