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 $70.79 Median $1,412.54 Typical High $7,943.28 | Facility | None | $70.79 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $151.36 Typical High $181.97 | Professional | None | $69.18 | $151.36 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $645.65 | Professional | None | $70.79 | $77.62 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $144.54 Typical High $194.98 | Professional | None | $67.61 | $144.54 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $363.08 | Professional | None | $154.88 | $181.97 | $363.08 |
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 $64.57 Median $144.54 Typical High $338.84 | Professional | None | $64.57 | $144.54 | $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 $34.67 Median $35.48 Typical High $79.43 | Professional | 52 · Reduced service | $34.67 | $35.48 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.13 Typical High $32.36 | Professional | 53 · Discontinued | $13.80 | $14.13 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $120.23 | Professional | 54 · Surgery only | $52.48 | $52.48 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $23.99 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $15.85 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $15.85 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 33rd 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.