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 $177.83 Median $1,621.81 Typical High $3,311.31 | Facility | None | $177.83 | $1,621.81 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $1,621.81 | Professional | None | $177.83 | $446.68 | $1,621.81 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $707.95 | Professional | None | $144.54 | $158.49 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $389.05 Typical High $1,584.89 | Professional | None | $147.91 | $389.05 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $1,380.38 Typical High $1,513.56 | Professional | None | $323.59 | $1,380.38 | $1,513.56 |
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 $134.90 Median $436.52 Typical High $1,905.46 | Professional | None | $134.90 | $436.52 | $1,905.46 |
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 $89.13 Median $89.13 Typical High $398.11 | Professional | 52 · Reduced service | $89.13 | $89.13 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $35.48 Typical High $158.49 | Professional | 53 · Discontinued | $35.48 | $35.48 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $131.83 Typical High $588.84 | Professional | 54 · Surgery only | $131.83 | $131.83 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $120.23 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $17.78 Typical High $79.43 | Professional | 56 · Pre-op care only | $17.78 | $17.78 | $79.43 |
Where Washington, DC sits
The same service costs 4.3 times more in Wisconsin 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· 43rd of 51
$447
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.