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 $1,862.09 Typical High $4,073.80 | Facility | None | $208.93 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | None | $194.98 | $208.93 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $223.87 | Professional | None | $173.78 | $194.98 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $302.00 | Professional | None | $134.90 | $169.82 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $371.54 | Professional | None | $131.83 | $147.91 | $371.54 |
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 $95.50 Median $158.49 Typical High $467.74 | Professional | None | $95.50 | $158.49 | $467.74 |
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 $97.72 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $38.90 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $144.54 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $20.89 |
Where Washington, DC sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 30th of 51
$195
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.