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 $199.53 Median $2,137.96 Typical High $12,589.25 | Facility | None | $199.53 | $2,137.96 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $275.42 Typical High $11,481.54 | Professional | None | $109.65 | $275.42 | $11,481.54 |
CareFirst Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $5,128.61 | Professional | None | $81.28 | $89.13 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $295.12 Typical High $11,220.18 | Professional | None | $81.28 | $295.12 | $11,220.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,964.78 | Professional | None | $10,000.00 | $10,000.00 | $10,964.78 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $11,220.18 Typical High $48,977.88 | Facility | None | $5,888.44 | $11,220.18 | $48,977.88 |
United Setting Professional Modifier None Typical Low $91.20 Median $269.15 Typical High $14,125.38 | Professional | None | $91.20 | $269.15 | $14,125.38 |
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 $54.95 Median $54.95 Typical High $2,951.21 | Professional | 52 · Reduced service | $54.95 | $54.95 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $1,202.26 | Professional | 53 · Discontinued | $21.88 | $21.88 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $4,466.84 | Professional | 54 · Surgery only | $81.28 | $81.28 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $891.25 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $588.84 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $588.84 |
Where Washington, DC sits
The same service costs 44.7 times more in Kansas than in Nebraska. 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· 48th of 51
$1,862
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.