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 $104.71 Median $288.40 Typical High $3,311.31 | Facility | None | $104.71 | $288.40 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $104.71 Typical High $257.04 | Professional | None | $60.26 | $104.71 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $645.65 | Professional | None | $60.26 | $66.07 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $281.84 | Professional | None | $56.23 | $100.00 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $239.88 | Professional | None | $112.20 | $134.90 | $239.88 |
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 $56.23 Median $107.15 Typical High $257.04 | Professional | None | $56.23 | $107.15 | $257.04 |
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 $30.20 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $30.20 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $12.02 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $45.71 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $9.12 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $10.47 |
Where Washington, DC sits
The same service costs 3.7 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· 31st of 51
$100
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.