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 $138.04 Median $2,818.38 Typical High $4,786.30 | Facility | None | $138.04 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $309.03 | Professional | None | $138.04 | $138.04 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $104.71 Median $125.89 Typical High $977.24 | Professional | None | $104.71 | $125.89 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $251.19 Typical High $630.96 | Professional | None | $112.20 | $251.19 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $524.81 Typical High $562.34 | Professional | None | $251.19 | $524.81 | $562.34 |
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 $104.71 Median $302.00 Typical High $724.44 | Professional | None | $104.71 | $302.00 | $724.44 |
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 $69.18 Median $69.18 Typical High $154.88 | Professional | 52 · Reduced service | $69.18 | $69.18 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $61.66 | Professional | 53 · Discontinued | $27.54 | $27.54 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $102.33 Typical High $229.09 | Professional | 54 · Surgery only | $102.33 | $102.33 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $30.90 |
Where Washington, DC sits
The same service costs 4.3 times more in Alaska 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· 24th of 51
$288
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.