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 $223.87 Median $2,818.38 Typical High $4,786.30 | Facility | None | $223.87 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $616.60 | Professional | None | $223.87 | $346.74 | $616.60 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $2,089.30 | Professional | None | $204.17 | $229.09 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $588.84 | Professional | None | $208.93 | $323.59 | $588.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $933.25 | Professional | None | $380.19 | $588.84 | $933.25 |
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 $208.93 Median $323.59 Typical High $691.83 | Professional | None | $208.93 | $323.59 | $691.83 |
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 $112.20 Median $112.20 Typical High $177.83 | Professional | 52 · Reduced service | $112.20 | $112.20 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 53 · Discontinued | $44.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | 54 · Surgery only | $165.96 | $165.96 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.11 Typical High $53.70 | Professional | 55 · Aftercare only | $33.11 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $35.48 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $35.48 |
Where Washington, DC sits
The same service costs 4.1 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· 41st of 51
$324
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.