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 $54.95 Median $141.25 Typical High $3,311.31 | Facility | None | $54.95 | $141.25 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $138.04 | Professional | None | $38.02 | $54.95 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $645.65 | Professional | None | $37.15 | $41.69 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $147.91 | Professional | None | $34.67 | $51.29 | $147.91 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $125.89 | Professional | None | $54.95 | $85.11 | $125.89 |
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 $32.36 Median $66.07 Typical High $134.90 | Professional | None | $32.36 | $66.07 | $134.90 |
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 $18.62 Median $23.99 Typical High $27.54 | Professional | 52 · Reduced service | $18.62 | $23.99 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $9.55 Typical High $10.96 | Professional | 53 · Discontinued | $7.41 | $9.55 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $36.31 Typical High $41.69 | Professional | 54 · Surgery only | $27.54 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $7.24 Typical High $8.32 | Professional | 55 · Aftercare only | $5.62 | $7.24 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.79 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.72 | $4.79 | $5.50 |
Where Washington, DC sits
The same service costs 4.2 times more in Alaska than in New York. 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· 36th of 51
$54.95
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.