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 $112.20 Median $3,090.30 Typical High $6,606.93 | Facility | None | $112.20 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $354.81 | Professional | None | $109.65 | $190.55 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $2,630.27 | Professional | None | $107.15 | $120.23 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $295.12 | Professional | None | $104.71 | $177.83 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $512.86 | Professional | None | $213.80 | $295.12 | $512.86 |
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 $100.00 Median $177.83 Typical High $416.87 | Professional | None | $100.00 | $177.83 | $416.87 |
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 $54.95 Median $54.95 Typical High $97.72 | Professional | 52 · Reduced service | $54.95 | $54.95 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $38.90 | Professional | 53 · Discontinued | $21.88 | $22.39 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $144.54 | Professional | 54 · Surgery only | $83.18 | $83.18 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $28.84 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $19.50 |
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· 35th of 51
$178
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.