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 $199.53 Median $616.60 Typical High $3,311.31 | Facility | None | $199.53 | $616.60 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $245.47 Typical High $588.84 | Professional | None | $102.33 | $245.47 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $977.24 | Professional | None | $77.62 | $95.50 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $213.80 Typical High $501.19 | Professional | None | $83.18 | $213.80 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $446.68 | Professional | None | $186.21 | $389.05 | $446.68 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $95.50 Median $229.09 Typical High $575.44 | Professional | None | $95.50 | $229.09 | $575.44 |
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 $51.29 Median $66.07 Typical High $123.03 | Professional | 52 · Reduced service | $51.29 | $66.07 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.30 Typical High $50.12 | Professional | 53 · Discontinued | $20.42 | $26.30 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $97.72 Typical High $186.21 | Professional | 54 · Surgery only | $77.62 | $97.72 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $37.15 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.18 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.23 | $13.18 | $24.55 |
Where Washington, DC sits
The same service costs 4.1 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· 38th of 51
$245
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.