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 $52.48 Median $1,412.54 Typical High $7,943.28 | Facility | None | $52.48 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $213.80 | Professional | None | $52.48 | $85.11 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $645.65 | Professional | None | $48.98 | $53.70 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $79.43 Typical High $141.25 | Professional | None | $48.98 | $79.43 | $141.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $194.98 | Professional | None | $93.33 | $120.23 | $194.98 |
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 $46.77 Median $75.86 Typical High $165.96 | Professional | None | $46.77 | $75.86 | $165.96 |
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 $26.30 Median $26.30 Typical High $42.66 | Professional | 52 · Reduced service | $26.30 | $26.30 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $16.98 | Professional | 53 · Discontinued | $10.47 | $10.47 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $39.81 Typical High $63.10 | Professional | 54 · Surgery only | $38.90 | $39.81 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $12.59 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $8.51 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $8.51 |
Where Washington, DC sits
The same service costs 3.4 times more in Alaska than in New York. 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· 42nd of 51
$72.44
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.