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 $616.60 Median $7,244.36 Typical High $10,232.93 | Facility | None | $616.60 | $7,244.36 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $7,413.10 | Professional | None | $616.60 | $1,258.93 | $7,413.10 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $17,782.79 | Professional | None | $478.63 | $524.81 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,348.96 Typical High $14,125.38 | Professional | None | $512.86 | $1,348.96 | $14,125.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $12,589.25 Typical High $14,125.38 | Professional | None | $1,122.02 | $12,589.25 | $14,125.38 |
United Setting Facility Modifier None Typical Low $14,791.08 Median $27,542.29 Typical High $70,794.58 | Facility | None | $14,791.08 | $27,542.29 | $70,794.58 |
United Setting Professional Modifier None Typical Low $501.19 Median $1,548.82 Typical High $17,782.79 | Professional | None | $501.19 | $1,548.82 | $17,782.79 |
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 $309.03 Median $309.03 Typical High $3,715.35 | Professional | 52 · Reduced service | $309.03 | $309.03 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $1,479.11 | Professional | 53 · Discontinued | $123.03 | $123.03 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $5,495.41 | Professional | 54 · Surgery only | $467.74 | $467.74 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $1,122.02 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $741.31 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $741.31 |
Where Washington, DC sits
The same service costs 17.8 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· 44th of 51
$4,169
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.