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 $1,000.00 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,000.00 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,071.52 | Professional | None | $891.25 | $1,000.00 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,380.38 | Professional | None | $954.99 | $1,047.13 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $2,691.53 | Professional | None | $891.25 | $954.99 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $1,995.26 Typical High $2,238.72 | Professional | None | $912.01 | $1,995.26 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,479.11 Typical High $2,754.23 | Professional | None | $831.76 | $1,479.11 | $2,754.23 |
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 $446.68 Median $501.19 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $107.15 |
Where Washington, DC sits
The same service costs 4.7 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· 40th of 51
$1,047
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.