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 $144.54 Median $389.05 Typical High $3,311.31 | Facility | None | $144.54 | $389.05 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $363.08 | Professional | None | $102.33 | $144.54 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $645.65 | Professional | None | $100.00 | $112.20 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $323.59 | Professional | None | $107.15 | $147.91 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $239.88 Typical High $467.74 | Professional | None | $154.88 | $239.88 | $467.74 |
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 $97.72 Median $162.18 Typical High $363.08 | Professional | None | $97.72 | $162.18 | $363.08 |
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 $51.29 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $51.29 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $107.15 Typical High $109.65 | Professional | 54 · Surgery only | $77.62 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $21.38 Typical High $21.88 | Professional | 55 · Aftercare only | $15.49 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.23 | $14.45 | $14.45 |
Where Washington, DC sits
The same service costs 3.1 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· 46th of 51
$148
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.