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 $97.72 Median $2,818.38 Typical High $4,786.30 | Facility | None | $97.72 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $208.93 Typical High $295.12 | Professional | None | $95.50 | $208.93 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $2,089.30 | Professional | None | $93.33 | $104.71 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $204.17 Typical High $616.60 | Professional | None | $89.13 | $204.17 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $524.81 | Professional | None | $223.87 | $275.42 | $524.81 |
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 $83.18 Median $208.93 Typical High $575.44 | Professional | None | $83.18 | $208.93 | $575.44 |
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 $47.86 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $47.86 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $19.50 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $72.44 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $14.45 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $9.55 | $19.50 | $23.44 |
Where Washington, DC sits
The same service costs 3.5 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· 30th of 51
$200
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.