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 $33.88 Median $1,412.54 Typical High $7,943.28 | Facility | None | $33.88 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $58.88 Typical High $112.20 | Professional | None | $31.62 | $58.88 | $112.20 |
CareFirst Setting Professional Modifier None Typical Low $33.88 Median $37.15 Typical High $645.65 | Professional | None | $33.88 | $37.15 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $89.13 Typical High $123.03 | Professional | None | $31.62 | $89.13 | $123.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $245.47 | Professional | None | $77.62 | $120.23 | $245.47 |
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 $30.90 Median $75.86 Typical High $213.80 | Professional | None | $30.90 | $75.86 | $213.80 |
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 $16.60 Median $16.98 Typical High $53.70 | Professional | 52 · Reduced service | $16.60 | $16.98 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $21.38 | Professional | 53 · Discontinued | $6.76 | $6.76 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $25.12 Typical High $81.28 | Professional | 54 · Surgery only | $25.12 | $25.12 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.13 Typical High $16.22 | Professional | 55 · Aftercare only | $5.01 | $5.13 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $10.72 |
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· 47th of 51
$64.57
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.