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 $275.42 Median $4,073.80 Typical High $7,079.46 | Facility | None | $275.42 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $338.84 | Professional | None | $251.19 | $275.42 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $630.96 | Professional | None | $275.42 | $302.00 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $741.31 | Professional | None | $257.04 | $269.15 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $549.54 Typical High $616.60 | Professional | None | $234.42 | $549.54 | $616.60 |
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 $218.78 Median $398.11 Typical High $758.58 | Professional | None | $218.78 | $398.11 | $758.58 |
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 $128.82 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 54 · Surgery only | $190.55 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $29.51 |
Where Washington, DC sits
The same service costs 5.5 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· 39th of 51
$302
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.