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 $29.51 Median $1,698.24 Typical High $4,073.80 | Facility | None | $29.51 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $64.57 | Professional | None | $29.51 | $29.51 | $64.57 |
CareFirst Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $549.54 | Professional | None | $26.30 | $28.84 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $58.88 Typical High $97.72 | Professional | None | $26.30 | $58.88 | $97.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $147.91 | Professional | None | $66.07 | $81.28 | $147.91 |
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 $27.54 Median $57.54 Typical High $138.04 | Professional | None | $27.54 | $57.54 | $138.04 |
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 $14.45 Median $14.45 Typical High $32.36 | Professional | 52 · Reduced service | $14.45 | $14.45 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $12.88 | Professional | 53 · Discontinued | $5.89 | $5.89 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $21.88 Typical High $47.86 | Professional | 54 · Surgery only | $21.88 | $21.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $7.94 Typical High $9.55 | Professional | 55 · Aftercare only | $4.37 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $2.95 | $5.25 | $6.46 |
Where Washington, DC sits
The same service costs 4.0 times more in Alaska than in Texas. 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· 40th of 51
$53.70
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.