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 $2,137.96 Typical High $7,943.28 | Facility | None | $1,000.00 | $2,137.96 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $2,511.89 | Professional | None | $933.25 | $1,000.00 | $2,511.89 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,202.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $2,754.23 | Professional | None | $912.01 | $977.24 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $912.01 Median $2,041.74 Typical High $2,290.87 | Professional | None | $912.01 | $2,041.74 | $2,290.87 |
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 $794.33 Median $1,479.11 Typical High $2,754.23 | Professional | None | $794.33 | $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 $213.80 | Professional | 53 · Discontinued | $181.97 | $199.53 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $100.00 Typical High $107.15 | Professional | 56 · Pre-op care only | $91.20 | $100.00 | $107.15 |
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· 38th of 51
$1,122
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.