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 $91.20 Median $1,698.24 Typical High $4,786.30 | Facility | None | $91.20 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $229.09 | Professional | None | $91.20 | $158.49 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $2,089.30 | Professional | None | $85.11 | $95.50 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $245.47 | Professional | None | $87.10 | $151.36 | $245.47 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $436.52 | Professional | None | $169.82 | $245.47 | $436.52 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $338.84 | Professional | None | $89.13 | $147.91 | $338.84 |
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 $45.71 Median $45.71 Typical High $81.28 | Professional | 52 · Reduced service | $45.71 | $45.71 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $32.36 | Professional | 53 · Discontinued | $18.20 | $18.20 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $67.61 Typical High $123.03 | Professional | 54 · Surgery only | $67.61 | $67.61 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.80 Typical High $24.55 | Professional | 55 · Aftercare only | $13.49 | $13.80 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $16.22 |
Where Washington, DC sits
The same service costs 3.2 times more in Alaska than in New Jersey. 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· 37th of 51
$151
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.