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 $54.95 Median $1,698.24 Typical High $4,073.80 | Facility | None | $54.95 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $97.72 Typical High $138.04 | Professional | None | $54.95 | $97.72 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $1,380.38 | Professional | None | $52.48 | $58.88 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $91.20 Typical High $154.88 | Professional | None | $51.29 | $91.20 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $223.87 | Professional | None | $102.33 | $125.89 | $223.87 |
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 $51.29 Median $89.13 Typical High $223.87 | Professional | None | $51.29 | $89.13 | $223.87 |
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 $27.54 Median $27.54 Typical High $48.98 | Professional | 52 · Reduced service | $27.54 | $27.54 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $19.50 | Professional | 53 · Discontinued | $10.96 | $10.96 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $72.44 | Professional | 54 · Surgery only | $41.69 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $14.45 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $9.77 |
Where Washington, DC sits
The same service costs 3.2 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· 40th of 51
$91.20
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.