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 $102.33 Median $1,548.82 Typical High $3,311.31 | Facility | None | $102.33 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $257.04 Typical High $660.69 | Professional | None | $102.33 | $257.04 | $660.69 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $2,137.96 | Professional | None | $79.43 | $95.50 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $223.87 Typical High $575.44 | Professional | None | $85.11 | $223.87 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $512.86 | Professional | None | $190.55 | $436.52 | $512.86 |
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 $257.04 Typical High $616.60 | Professional | None | $95.50 | $257.04 | $616.60 |
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 $64.57 Typical High $141.25 | Professional | 52 · Reduced service | $51.29 | $64.57 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $56.23 | Professional | 53 · Discontinued | $20.42 | $25.70 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $97.72 Typical High $213.80 | Professional | 54 · Surgery only | $77.62 | $97.72 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $42.66 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $28.18 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $28.18 |
Where Washington, DC sits
The same service costs 4.1 times more in Wisconsin 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· 32nd of 51
$257
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.