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 $64.57 Median $1,412.54 Typical High $7,943.28 | Facility | None | $64.57 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $109.65 | Professional | None | $64.57 | $64.57 | $109.65 |
CareFirst Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $630.96 | Professional | None | $52.48 | $57.54 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $114.82 Typical High $229.09 | Professional | None | $52.48 | $114.82 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $204.17 | Professional | None | $120.23 | $165.96 | $204.17 |
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 $53.70 Median $128.82 Typical High $245.47 | Professional | None | $53.70 | $128.82 | $245.47 |
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 $32.36 Median $32.36 Typical High $54.95 | Professional | 52 · Reduced service | $32.36 | $32.36 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $21.88 | Professional | 53 · Discontinued | $13.18 | $13.18 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $83.18 | Professional | 54 · Surgery only | $48.98 | $48.98 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $16.60 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $10.96 |
Where Washington, DC sits
The same service costs 3.7 times more in Wisconsin 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· 24th 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.