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 $107.15 Median $1,548.82 Typical High $3,311.31 | Facility | None | $107.15 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $354.81 | Professional | None | $107.15 | $169.82 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $2,454.71 | Professional | None | $79.43 | $89.13 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $346.74 | Professional | None | $79.43 | $162.18 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $295.12 | Professional | None | $275.42 | $275.42 | $295.12 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $89.13 Median $194.98 Typical High $380.19 | Professional | None | $89.13 | $194.98 | $380.19 |
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 $53.70 Median $53.70 Typical High $85.11 | Professional | 52 · Reduced service | $53.70 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $33.88 | Professional | 53 · Discontinued | $21.38 | $21.38 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $81.28 Typical High $128.82 | Professional | 54 · Surgery only | $81.28 | $81.28 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $25.70 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $16.98 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $16.98 |
Where Washington, DC sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 32nd of 51
$170
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.