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 $169.82 Median $1,698.24 Typical High $4,073.80 | Facility | None | $169.82 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $426.58 | Professional | None | $158.49 | $169.82 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $245.47 | Professional | None | $169.82 | $190.55 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $467.74 | Professional | None | $158.49 | $165.96 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $389.05 | Professional | None | $151.36 | $346.74 | $389.05 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $134.90 Median $245.47 Typical High $467.74 | Professional | None | $134.90 | $245.47 | $467.74 |
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 $75.86 Median $85.11 Typical High $91.20 | Professional | 52 · Reduced service | $75.86 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.88 Typical High $36.31 | Professional | 53 · Discontinued | $30.90 | $33.88 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $128.82 Typical High $138.04 | Professional | 54 · Surgery only | $114.82 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.70 Typical High $27.54 | Professional | 55 · Aftercare only | $22.91 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $16.98 Typical High $18.20 | Professional | 56 · Pre-op care only | $15.14 | $16.98 | $18.20 |
Where Washington, DC sits
The same service costs 4.2 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· 38th of 51
$191
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.