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 $141.25 Median $1,862.09 Typical High $4,073.80 | Facility | None | $141.25 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $338.84 | Professional | None | $123.03 | $141.25 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $741.31 | Professional | None | $131.83 | $147.91 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $380.19 | Professional | None | $107.15 | $134.90 | $380.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $257.04 Typical High $323.59 | Professional | None | $131.83 | $257.04 | $323.59 |
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 $102.33 Median $186.21 Typical High $389.05 | Professional | None | $102.33 | $186.21 | $389.05 |
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 $64.57 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $64.57 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $25.70 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $19.50 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.88 | $14.13 | $14.13 |
Where Washington, DC sits
The same service costs 5.6 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
$148
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.