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 $11.22 Median $11.22 Typical High $40.74 | Facility | None | $11.22 | $11.22 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $28.18 Typical High $87.10 | Professional | None | $11.22 | $28.18 | $87.10 |
CareFirst Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $630.96 | Professional | None | $8.71 | $9.55 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $30.20 Typical High $87.10 | Professional | None | $8.51 | $30.20 | $87.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $20.89 Median $56.23 Typical High $75.86 | Professional | None | $20.89 | $56.23 | $75.86 |
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 $8.32 Median $26.92 Typical High $91.20 | Professional | None | $8.32 | $26.92 | $91.20 |
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 $5.62 Median $5.62 Typical High $20.42 | Professional | 52 · Reduced service | $5.62 | $5.62 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $8.13 | Professional | 53 · Discontinued | $2.24 | $2.24 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $8.51 Typical High $30.20 | Professional | 54 · Surgery only | $8.51 | $8.51 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $6.03 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $4.07 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $4.07 |
Where Washington, DC sits
The same service costs 4.2 times more in Wisconsin 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· 42nd of 51
$28.18
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.