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 $61.66 Median $1,862.09 Typical High $4,073.80 | Facility | None | $61.66 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $61.66 | Professional | None | $57.54 | $61.66 | $61.66 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $66.07 | Professional | None | $51.29 | $57.54 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $107.15 | Professional | None | $46.77 | $50.12 | $107.15 |
Kaiser Permanente Setting Professional Modifier None Typical Low $38.90 Median $42.66 Typical High $109.65 | Professional | None | $38.90 | $42.66 | $109.65 |
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 $41.69 Median $46.77 Typical High $134.90 | Professional | None | $41.69 | $46.77 | $134.90 |
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 $28.84 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $11.48 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 54 · Surgery only | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.17 |
Where Washington, DC sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 41st of 51
$57.54
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.