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 $95.50 Median $1,412.54 Typical High $7,943.28 | Facility | None | $95.50 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $190.55 | Professional | None | $93.33 | $120.23 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $645.65 | Professional | None | $95.50 | $104.71 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $173.78 Typical High $251.19 | Professional | None | $89.13 | $173.78 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $436.52 | Professional | None | $186.21 | $218.78 | $436.52 |
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 $89.13 Median $173.78 Typical High $407.38 | Professional | None | $89.13 | $173.78 | $407.38 |
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 $46.77 Median $47.86 Typical High $95.50 | Professional | 52 · Reduced service | $46.77 | $47.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.05 Typical High $38.02 | Professional | 53 · Discontinued | $18.62 | $19.05 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $141.25 | Professional | 54 · Surgery only | $70.79 | $70.79 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $28.18 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.55 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.33 | $9.55 | $19.05 |
Where Washington, DC sits
The same service costs 3.3 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· 47th of 51
$135
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.