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 $380.19 Median $5,888.44 Typical High $10,232.93 | Facility | None | $380.19 | $5,888.44 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $954.99 Typical High $13,803.84 | Professional | None | $380.19 | $954.99 | $13,803.84 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $15,488.17 | Professional | None | $295.12 | $323.59 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $831.76 Typical High $11,220.18 | Professional | None | $316.23 | $831.76 | $11,220.18 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $10,000.00 Typical High $11,481.54 | Professional | None | $707.95 | $10,000.00 | $11,481.54 |
United Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $48,977.88 | Facility | None | $5,888.44 | $10,000.00 | $48,977.88 |
United Setting Professional Modifier None Typical Low $302.00 Median $954.99 Typical High $13,803.84 | Professional | None | $302.00 | $954.99 | $13,803.84 |
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 $190.55 Median $190.55 Typical High $2,951.21 | Professional | 52 · Reduced service | $190.55 | $190.55 | $2,951.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $75.86 Typical High $1,174.90 | Professional | 53 · Discontinued | $75.86 | $75.86 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $288.40 Typical High $4,365.16 | Professional | 54 · Surgery only | $288.40 | $288.40 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $870.96 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $38.02 Typical High $588.84 | Professional | 56 · Pre-op care only | $38.02 | $38.02 | $588.84 |
Where Washington, DC sits
The same service costs 20.0 times more in Alaska than in Hawaii. 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· 47th of 51
$1,413
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.