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 $120.23 Median $1,862.09 Typical High $4,073.80 | Facility | None | $120.23 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | None | $114.82 | $120.23 | $120.23 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | None | $100.00 | $109.65 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $204.17 | Professional | None | $93.33 | $97.72 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $213.80 | Professional | None | $75.86 | $83.18 | $213.80 |
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 $81.28 Median $95.50 Typical High $263.03 | Professional | None | $81.28 | $95.50 | $263.03 |
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 $57.54 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $57.54 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $87.10 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $17.38 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $11.48 | $12.02 | $12.02 |
Where Washington, DC sits
The same service costs 4.0 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
$110
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.