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 $91.20 Median $1,698.24 Typical High $4,073.80 | Facility | None | $91.20 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $229.09 | Professional | None | $91.20 | $144.54 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $645.65 | Professional | None | $85.11 | $93.33 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $239.88 | Professional | None | $85.11 | $138.04 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $346.74 | Professional | None | $154.88 | $213.80 | $346.74 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $316.23 | Professional | None | $85.11 | $138.04 | $316.23 |
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 $45.71 Median $45.71 Typical High $74.13 | Professional | 52 · Reduced service | $45.71 | $45.71 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.62 Typical High $29.51 | Professional | 53 · Discontinued | $18.20 | $18.62 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $112.20 | Professional | 54 · Surgery only | $69.18 | $69.18 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $22.39 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $14.79 |
Where Washington, DC sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 39th of 51
$138
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.