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 $81.28 Median $1,698.24 Typical High $4,073.80 | Facility | None | $81.28 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $199.53 Typical High $537.03 | Professional | None | $81.28 | $199.53 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $2,137.96 | Professional | None | $60.26 | $67.61 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $173.78 Typical High $501.19 | Professional | None | $64.57 | $173.78 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $436.52 Typical High $457.09 | Professional | None | $144.54 | $436.52 | $457.09 |
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 $61.66 Median $199.53 Typical High $616.60 | Professional | None | $61.66 | $199.53 | $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 $39.81 Median $39.81 Typical High $125.89 | Professional | 52 · Reduced service | $39.81 | $39.81 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $51.29 | Professional | 53 · Discontinued | $16.22 | $16.22 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $60.26 Typical High $190.55 | Professional | 54 · Surgery only | $60.26 | $60.26 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $38.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $25.12 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $25.12 |
Where Washington, DC sits
The same service costs 5.0 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· 46th of 51
$200
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.