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 $58.88 Median $346.74 Typical High $4,073.80 | Facility | None | $58.88 | $346.74 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $93.33 Typical High $151.36 | Professional | None | $58.88 | $93.33 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $645.65 | Professional | None | $58.88 | $66.07 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $131.83 Typical High $177.83 | Professional | None | $56.23 | $131.83 | $177.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $331.13 | Professional | None | $138.04 | $162.18 | $331.13 |
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 $54.95 Median $131.83 Typical High $309.03 | Professional | None | $54.95 | $131.83 | $309.03 |
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 $29.51 Median $29.51 Typical High $72.44 | Professional | 52 · Reduced service | $29.51 | $29.51 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $28.84 | Professional | 53 · Discontinued | $11.75 | $11.75 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $44.67 Typical High $109.65 | Professional | 54 · Surgery only | $43.65 | $44.67 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $21.88 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $14.45 |
Where Washington, DC sits
The same service costs 3.5 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
$102
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.