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 $2.00 Median $1,698.24 Typical High $4,073.80 | Facility | None | $2.00 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $5.13 Typical High $10.00 | Professional | None | $2.00 | $5.13 | $10.00 |
CareFirst Setting Professional Modifier None Typical Low $2.00 Median $2.19 Typical High $630.96 | Professional | None | $2.00 | $2.19 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $6.46 Typical High $12.88 | Professional | None | $1.86 | $6.46 | $12.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6.76 Median $7.94 Typical High $15.85 | Professional | None | $6.76 | $7.94 | $15.85 |
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 $1.91 Median $5.37 Typical High $16.98 | Professional | None | $1.91 | $5.37 | $16.98 |
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 $1.00 Median $1.12 Typical High $3.55 | Professional | 52 · Reduced service | $1.00 | $1.12 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.45 Typical High $1.41 | Professional | 53 · Discontinued | $0.40 | $0.45 | $1.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.48 Median $1.70 Typical High $5.25 | Professional | 54 · Surgery only | $1.48 | $1.70 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.34 Typical High $1.07 | Professional | 55 · Aftercare only | $0.30 | $0.34 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.49 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.20 | $0.49 | $0.71 |
Where Washington, DC sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$5.37
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.