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 $41.69 Median $1,548.82 Typical High $3,311.31 | Facility | None | $41.69 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $169.82 | Professional | None | $41.69 | $67.61 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $645.65 | Professional | None | $40.74 | $45.71 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $66.07 Typical High $186.21 | Professional | None | $38.90 | $66.07 | $186.21 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $95.50 Typical High $154.88 | Professional | None | $72.44 | $95.50 | $154.88 |
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 $38.02 Median $70.79 Typical High $169.82 | Professional | None | $38.02 | $70.79 | $169.82 |
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 $20.89 Median $27.54 Typical High $33.88 | Professional | 52 · Reduced service | $20.89 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $11.22 Typical High $13.49 | Professional | 53 · Discontinued | $8.32 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $41.69 Typical High $51.29 | Professional | 54 · Surgery only | $31.62 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.32 Typical High $10.23 | Professional | 55 · Aftercare only | $6.31 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.62 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.17 | $5.62 | $6.76 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$66.07
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.