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 $186.21 Median $2,818.38 Typical High $4,786.30 | Facility | None | $186.21 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $1,949.84 | Professional | None | $186.21 | $186.21 | $1,949.84 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $2,137.96 | Professional | None | $144.54 | $158.49 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $407.38 Typical High $3,630.78 | Professional | None | $151.36 | $407.38 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $3,235.94 Typical High $3,467.37 | Professional | None | $338.84 | $3,235.94 | $3,467.37 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $151.36 Median $457.09 Typical High $4,466.84 | Professional | None | $151.36 | $457.09 | $4,466.84 |
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 $93.33 Median $93.33 Typical High $954.99 | Professional | 52 · Reduced service | $93.33 | $93.33 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $37.15 Typical High $389.05 | Professional | 53 · Discontinued | $37.15 | $37.15 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $141.25 Typical High $1,445.44 | Professional | 54 · Surgery only | $141.25 | $141.25 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $288.40 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $18.62 Typical High $194.98 | Professional | 56 · Pre-op care only | $18.62 | $18.62 | $194.98 |
Where Washington, DC sits
The same service costs 8.5 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· 44th of 51
$1,072
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.