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 $776.25 Median $1,862.09 Typical High $4,073.80 | Facility | None | $776.25 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,949.84 | Professional | None | $707.95 | $776.25 | $1,949.84 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,023.29 | Professional | None | $851.14 | $933.25 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $758.58 Typical High $2,089.30 | Professional | None | $724.44 | $758.58 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $1,737.80 | Professional | None | $691.83 | $1,584.89 | $1,737.80 |
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 $616.60 Median $1,122.02 Typical High $2,137.96 | Professional | None | $616.60 | $1,122.02 | $2,137.96 |
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 $346.74 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $117.49 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $83.18 |
Where Washington, DC sits
The same service costs 4.7 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· 37th of 51
$871
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.