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 $812.83 Median $1,862.09 Typical High $4,073.80 | Facility | None | $812.83 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $891.25 | Professional | None | $758.58 | $812.83 | $891.25 |
CareFirst Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,096.48 | Professional | None | $912.01 | $1,000.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $2,238.72 | Professional | None | $776.25 | $831.76 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $1,659.59 Typical High $1,819.70 | Professional | None | $707.95 | $1,659.59 | $1,819.70 |
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 $691.83 Median $1,202.26 Typical High $2,238.72 | Professional | None | $691.83 | $1,202.26 | $2,238.72 |
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 $371.54 Median $407.38 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $89.13 |
Where Washington, DC sits
The same service costs 5.0 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· 34th of 51
$1,000
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.