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 $363.08 Median $1,862.09 Typical High $4,073.80 | Facility | None | $363.08 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $389.05 | Professional | None | $323.59 | $363.08 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $489.78 | Professional | None | $371.54 | $407.38 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $1,000.00 | Professional | None | $338.84 | $363.08 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $741.31 Typical High $831.76 | Professional | None | $331.13 | $741.31 | $831.76 |
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 $295.12 Median $537.03 Typical High $1,000.00 | Professional | None | $295.12 | $537.03 | $1,000.00 |
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 $165.96 Median $181.97 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $79.43 | Professional | 53 · Discontinued | $66.07 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $275.42 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $39.81 |
Where Washington, DC sits
The same service costs 4.5 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· 39th of 51
$407
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.