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 $74.13 Median $1,412.54 Typical High $7,943.28 | Facility | None | $74.13 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $165.96 | Professional | None | $72.44 | $93.33 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $645.65 | Professional | None | $72.44 | $81.28 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $147.91 Typical High $199.53 | Professional | None | $69.18 | $147.91 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $371.54 | Professional | None | $158.49 | $186.21 | $371.54 |
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 $69.18 Median $147.91 Typical High $354.81 | Professional | None | $69.18 | $147.91 | $354.81 |
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 $37.15 Median $37.15 Typical High $83.18 | Professional | 52 · Reduced service | $37.15 | $37.15 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $33.11 | Professional | 53 · Discontinued | $14.79 | $14.79 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $123.03 | Professional | 54 · Surgery only | $56.23 | $56.23 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $24.55 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $16.60 |
Where Washington, DC sits
The same service costs 3.2 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· 48th of 51
$110
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.