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 $16.22 Median $1,412.54 Typical High $7,943.28 | Facility | None | $16.22 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $30.90 | Professional | None | $16.22 | $16.22 | $30.90 |
CareFirst Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $549.54 | Professional | None | $16.22 | $17.78 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $28.84 Typical High $61.66 | Professional | None | $15.85 | $28.84 | $61.66 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $93.33 | Professional | None | $33.11 | $38.90 | $93.33 |
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 $15.85 Median $38.90 Typical High $74.13 | Professional | None | $15.85 | $38.90 | $74.13 |
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 $8.13 Median $8.13 Typical High $15.49 | Professional | 52 · Reduced service | $8.13 | $8.13 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $6.17 | Professional | 53 · Discontinued | $3.24 | $3.24 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $12.02 Typical High $23.44 | Professional | 54 · Surgery only | $12.02 | $12.02 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.45 Typical High $4.68 | Professional | 55 · Aftercare only | $2.40 | $2.45 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $3.09 |
Where Washington, DC sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 44th of 51
$28.84
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.