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 $18.20 Median $18.20 Typical High $35.48 | Facility | None | $18.20 | $18.20 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $35.48 Typical High $75.86 | Professional | None | $18.20 | $35.48 | $75.86 |
CareFirst Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $645.65 | Professional | None | $14.13 | $15.49 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $30.20 Typical High $74.13 | Professional | None | $14.79 | $30.20 | $74.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $64.57 | Professional | None | $33.88 | $63.10 | $64.57 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $14.45 Median $34.67 Typical High $87.10 | Professional | None | $14.45 | $34.67 | $87.10 |
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 $9.12 Median $9.12 Typical High $17.78 | Professional | 52 · Reduced service | $9.12 | $9.12 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $7.08 | Professional | 53 · Discontinued | $3.63 | $3.63 | $7.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $13.80 Typical High $26.92 | Professional | 54 · Surgery only | $13.80 | $13.80 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $5.37 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $3.55 |
Where Washington, DC sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 27th of 51
$33.88
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.