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 $125.89 Median $2,818.38 Typical High $4,786.30 | Facility | None | $125.89 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $562.34 | Professional | None | $125.89 | $229.09 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $117.49 Typical High $741.31 | Professional | None | $107.15 | $117.49 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $331.13 | Professional | None | $128.82 | $223.87 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $524.81 | Professional | None | $288.40 | $331.13 | $524.81 |
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 $120.23 Median $204.17 Typical High $467.74 | Professional | None | $120.23 | $204.17 | $467.74 |
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 $63.10 Median $63.10 Typical High $112.20 | Professional | 52 · Reduced service | $63.10 | $63.10 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $45.71 | Professional | 53 · Discontinued | $25.12 | $25.70 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $95.50 Typical High $169.82 | Professional | 54 · Surgery only | $93.33 | $95.50 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.05 Typical High $33.88 | Professional | 55 · Aftercare only | $18.62 | $19.05 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $22.91 |
Where Washington, DC sits
The same service costs 3.3 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
$214
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.