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 $269.15 Median $3,090.30 Typical High $6,606.93 | Facility | None | $269.15 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $676.08 Typical High $5,370.32 | Professional | None | $269.15 | $676.08 | $5,370.32 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $4,365.16 | Professional | None | $218.78 | $239.88 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $724.44 Typical High $5,370.32 | Professional | None | $199.53 | $724.44 | $5,370.32 |
Kaiser Permanente Setting Professional Modifier None Typical Low $489.78 Median $4,786.30 Typical High $5,248.07 | Professional | None | $489.78 | $4,786.30 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $229.09 Median $660.69 Typical High $6,606.93 | Professional | None | $229.09 | $660.69 | $6,606.93 |
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 $134.90 Median $134.90 Typical High $1,380.38 | Professional | 52 · Reduced service | $134.90 | $134.90 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $549.54 | Professional | 53 · Discontinued | $53.70 | $53.70 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $2,089.30 | Professional | 54 · Surgery only | $199.53 | $199.53 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $416.87 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $275.42 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $275.42 |
Where Washington, DC sits
The same service costs 10.0 times more in Wisconsin than in Nebraska. 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
$1,905
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.