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 $131.83 Median $2,818.38 Typical High $4,786.30 | Facility | None | $131.83 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | None | $107.15 | $131.83 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $131.83 | Professional | None | $95.50 | $107.15 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $107.15 Typical High $181.97 | Professional | None | $100.00 | $107.15 | $181.97 |
Kaiser Permanente Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $234.42 | Professional | None | $79.43 | $89.13 | $234.42 |
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 $72.44 Median $100.00 Typical High $288.40 | Professional | None | $72.44 | $100.00 | $288.40 |
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 $61.66 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $24.55 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $91.20 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $18.20 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.30 | $13.18 | $13.18 |
Where Washington, DC sits
The same service costs 4.8 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· 45th of 51
$107
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.