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 $2,818.38 Typical High $4,786.30 | Facility | None | $120.23 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $1,862.09 | Professional | None | $120.23 | $120.23 | $1,862.09 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $4,570.88 | Professional | None | $87.10 | $97.72 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $257.04 Typical High $3,715.35 | Professional | None | $97.72 | $257.04 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $3,235.94 Typical High $4,677.35 | Professional | None | $218.78 | $3,235.94 | $4,677.35 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $10,232.93 Typical High $34,673.69 | Facility | None | $2,290.87 | $10,232.93 | $34,673.69 |
United Setting Professional Modifier None Typical Low $91.20 Median $724.44 Typical High $4,466.84 | Professional | None | $91.20 | $724.44 | $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 $58.88 Median $58.88 Typical High $933.25 | Professional | 52 · Reduced service | $58.88 | $58.88 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $371.54 | Professional | 53 · Discontinued | $23.99 | $23.99 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $89.13 Typical High $1,380.38 | Professional | 54 · Surgery only | $89.13 | $89.13 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $275.42 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $186.21 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $186.21 |
Where Washington, DC sits
The same service costs 19.1 times more in Alaska 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· 49th of 51
$295
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.