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 $109.65 Median $1,698.24 Typical High $4,786.30 | Facility | None | $109.65 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $389.05 | Professional | None | $109.65 | $162.18 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $741.31 | Professional | None | $102.33 | $114.82 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $295.12 | Professional | None | $112.20 | $158.49 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $380.19 | Professional | None | $177.83 | $263.03 | $380.19 |
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 $147.91 Typical High $323.59 | Professional | None | $100.00 | $147.91 | $323.59 |
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 $81.28 | Professional | 52 · Reduced service | $54.95 | $54.95 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $32.36 | Professional | 53 · Discontinued | $21.88 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $83.18 Typical High $120.23 | Professional | 54 · Surgery only | $81.28 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $23.99 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $16.22 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 40th of 51
$148
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.