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 $398.11 Median $2,137.96 Typical High $4,570.88 | Facility | None | $398.11 | $2,137.96 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,000.00 Typical High $4,570.88 | Professional | None | $398.11 | $1,000.00 | $4,570.88 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $1,318.26 | Professional | None | $316.23 | $389.05 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $870.96 Typical High $4,677.35 | Professional | None | $323.59 | $870.96 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $4,073.80 Typical High $4,168.69 | Professional | None | $724.44 | $4,073.80 | $4,168.69 |
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 $323.59 Median $977.24 Typical High $5,623.41 | Professional | None | $323.59 | $977.24 | $5,623.41 |
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 $199.53 Median $218.78 Typical High $1,174.90 | Professional | 52 · Reduced service | $199.53 | $218.78 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $467.74 | Professional | 53 · Discontinued | $79.43 | $87.10 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $331.13 Typical High $1,778.28 | Professional | 54 · Surgery only | $295.12 | $331.13 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $354.81 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $234.42 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $234.42 |
Where Washington, DC sits
The same service costs 6.3 times more in Oregon than in Delaware. 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· 28th of 51
$871
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.