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 $501.19 Median $1,862.09 Typical High $4,073.80 | Facility | None | $501.19 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $1,148.15 | Professional | None | $457.09 | $501.19 | $1,148.15 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $630.96 | Professional | None | $524.81 | $588.84 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $1,348.96 | Professional | None | $467.74 | $467.74 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $446.68 Median $1,023.29 Typical High $1,122.02 | Professional | None | $446.68 | $1,023.29 | $1,122.02 |
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 $436.52 Median $741.31 Typical High $1,380.38 | Professional | None | $436.52 | $741.31 | $1,380.38 |
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 $223.87 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $371.54 Typical High $398.11 | Professional | 54 · Surgery only | $331.13 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $50.12 | $53.70 |
Where Washington, DC sits
The same service costs 4.3 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· 40th of 51
$550
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.