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 $346.74 Median $3,388.44 Typical High $6,606.93 | Facility | None | $346.74 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $812.83 | Professional | None | $331.13 | $346.74 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $3,235.94 | Professional | None | $331.13 | $371.54 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $954.99 | Professional | None | $331.13 | $588.84 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $316.23 Median $707.95 Typical High $794.33 | Professional | None | $316.23 | $707.95 | $794.33 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $323.59 Median $588.84 Typical High $954.99 | Professional | None | $323.59 | $588.84 | $954.99 |
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 $169.82 Median $173.78 Typical High $281.84 | Professional | 52 · Reduced service | $169.82 | $173.78 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $70.79 Typical High $112.20 | Professional | 53 · Discontinued | $67.61 | $70.79 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $263.03 Typical High $426.58 | Professional | 54 · Surgery only | $251.19 | $263.03 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $85.11 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $56.23 |
Where Washington, DC sits
The same service costs 4.7 times more in Alaska than in Utah. 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· 35th of 51
$513
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.