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 $208.93 Median $1,698.24 Typical High $3,311.31 | Facility | None | $208.93 | $1,698.24 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $524.81 Typical High $2,290.87 | Professional | None | $208.93 | $524.81 | $2,290.87 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $707.95 | Professional | None | $173.78 | $190.55 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $562.34 Typical High $2,238.72 | Professional | None | $162.18 | $562.34 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $389.05 Median $1,819.70 Typical High $1,995.26 | Professional | None | $389.05 | $1,819.70 | $1,995.26 |
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 $162.18 Median $524.81 Typical High $2,630.27 | Professional | None | $162.18 | $524.81 | $2,630.27 |
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 $104.71 Median $104.71 Typical High $562.34 | Professional | 52 · Reduced service | $104.71 | $104.71 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $223.87 | Professional | 53 · Discontinued | $41.69 | $41.69 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $851.14 | Professional | 54 · Surgery only | $158.49 | $158.49 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $169.82 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $112.20 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $112.20 |
Where Washington, DC sits
The same service costs 4.5 times more in Oregon 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· 39th of 51
$525
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.