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 $120.23 Median $331.13 Typical High $3,311.31 | Facility | None | $120.23 | $331.13 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $208.93 | Professional | None | $70.79 | $117.49 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $630.96 | Professional | None | $61.66 | $69.18 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $190.55 | Professional | None | $72.44 | $109.65 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $275.42 | Professional | None | $128.82 | $165.96 | $275.42 |
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 $66.07 Median $112.20 Typical High $269.15 | Professional | None | $66.07 | $112.20 | $269.15 |
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 $35.48 Median $35.48 Typical High $60.26 | Professional | 52 · Reduced service | $35.48 | $35.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $23.99 | Professional | 53 · Discontinued | $14.13 | $14.13 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $53.70 Typical High $91.20 | Professional | 54 · Surgery only | $52.48 | $53.70 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $18.20 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $12.02 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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
$112
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.