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 $251.19 Median $3,548.13 Typical High $4,786.30 | Facility | None | $251.19 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $257.04 | Professional | None | $218.78 | $251.19 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $2,570.40 | Professional | None | $190.55 | $213.80 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $676.08 | Professional | None | $223.87 | $239.88 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $501.19 Typical High $562.34 | Professional | None | $223.87 | $501.19 | $562.34 |
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 $194.98 Median $309.03 Typical High $676.08 | Professional | None | $194.98 | $309.03 | $676.08 |
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 $109.65 Median $123.03 Typical High $128.82 | Professional | 52 · Reduced service | $109.65 | $123.03 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $50.12 Typical High $51.29 | Professional | 53 · Discontinued | $43.65 | $50.12 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $186.21 Typical High $194.98 | Professional | 54 · Surgery only | $162.18 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $37.15 Typical High $38.90 | Professional | 55 · Aftercare only | $33.11 | $37.15 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $21.88 | $25.12 | $25.70 |
Where Washington, DC sits
The same service costs 5.0 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· 41st of 51
$251
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.