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 $281.84 Typical High $4,073.80 | Facility | None | $54.95 | $281.84 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $117.49 Typical High $281.84 | Professional | None | $54.95 | $117.49 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $645.65 | Professional | None | $44.67 | $48.98 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $109.65 Typical High $151.36 | Professional | None | $56.23 | $109.65 | $151.36 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $269.15 | Professional | None | $128.82 | $173.78 | $269.15 |
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 $52.48 Median $107.15 Typical High $239.88 | Professional | None | $52.48 | $107.15 | $239.88 |
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 $26.92 Median $27.54 Typical High $58.88 | Professional | 52 · Reduced service | $26.92 | $27.54 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $23.44 | Professional | 53 · Discontinued | $10.96 | $10.96 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $40.74 Typical High $87.10 | Professional | 54 · Surgery only | $40.74 | $40.74 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.32 Typical High $17.78 | Professional | 55 · Aftercare only | $8.13 | $8.32 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $11.75 |
Where Washington, DC sits
The same service costs 3.0 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· 34th of 51
$110
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.