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 $123.03 Median $1,862.09 Typical High $4,073.80 | Facility | None | $123.03 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $125.89 | Professional | None | $112.20 | $123.03 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $549.54 | Professional | None | $144.54 | $158.49 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $331.13 | Professional | None | $112.20 | $120.23 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $269.15 | Professional | None | $125.89 | $245.47 | $269.15 |
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 $95.50 Median $158.49 Typical High $331.13 | Professional | None | $95.50 | $158.49 | $331.13 |
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 $56.23 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $22.39 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $91.20 Typical High $95.50 | Professional | 54 · Surgery only | $85.11 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.22 | $12.30 | $12.88 |
Where Washington, DC sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 24th of 51
$158
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.