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 $20.89 Median $1,698.24 Typical High $4,073.80 | Facility | None | $20.89 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $41.69 Typical High $77.62 | Professional | None | $20.89 | $41.69 | $77.62 |
CareFirst Setting Professional Modifier None Typical Low $17.78 Median $19.95 Typical High $645.65 | Professional | None | $17.78 | $19.95 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $43.65 Typical High $61.66 | Professional | None | $21.88 | $43.65 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $107.15 | Professional | None | $47.86 | $54.95 | $107.15 |
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 $22.91 Median $42.66 Typical High $97.72 | Professional | None | $22.91 | $42.66 | $97.72 |
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 $10.47 Median $10.47 Typical High $20.89 | Professional | 52 · Reduced service | $10.47 | $10.47 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $8.32 | Professional | 53 · Discontinued | $4.17 | $4.17 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $15.85 Typical High $30.90 | Professional | 54 · Surgery only | $15.85 | $15.85 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $6.31 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $3.39 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.09 | $3.39 | $4.17 |
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· 37th of 51
$41.69
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.