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 $741.31 Median $1,862.09 Typical High $4,073.80 | Facility | None | $741.31 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,862.09 | Professional | None | $676.08 | $741.31 | $1,862.09 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $870.96 Typical High $977.24 | Professional | None | $630.96 | $870.96 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $2,041.74 | Professional | None | $691.83 | $724.44 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $1,513.56 Typical High $1,698.24 | Professional | None | $676.08 | $1,513.56 | $1,698.24 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,096.48 Typical High $2,041.74 | Professional | None | $588.84 | $1,096.48 | $2,041.74 |
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 $331.13 Median $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $331.13 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $131.83 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $562.34 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $120.23 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $79.43 |
Where Washington, DC sits
The same service costs 4.6 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· 36th 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.