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 $407.38 Median $1,862.09 Typical High $4,073.80 | Facility | None | $407.38 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $416.87 | Professional | None | $371.54 | $407.38 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $676.08 | Professional | None | $562.34 | $616.60 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $1,122.02 | Professional | None | $363.08 | $389.05 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $794.33 Typical High $912.01 | Professional | None | $389.05 | $794.33 | $912.01 |
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 $302.00 Median $524.81 Typical High $1,122.02 | Professional | None | $302.00 | $524.81 | $1,122.02 |
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 $186.21 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $186.21 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $74.13 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $302.00 Typical High $316.23 | Professional | 54 · Surgery only | $281.84 | $302.00 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $41.69 |
Where Washington, DC sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 20th of 51
$562
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.