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 $371.54 Median $3,981.07 Typical High $7,943.28 | Facility | None | $371.54 | $3,981.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $933.25 Typical High $9,332.54 | Professional | None | $371.54 | $933.25 | $9,332.54 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $10,715.19 | Professional | None | $288.40 | $316.23 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $1,000.00 Typical High $9,120.11 | Professional | None | $281.84 | $1,000.00 | $9,120.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $7,762.47 Typical High $8,317.64 | Professional | None | $676.08 | $7,762.47 | $8,317.64 |
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 $316.23 Median $933.25 Typical High $10,000.00 | Professional | None | $316.23 | $933.25 | $10,000.00 |
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 $186.21 Median $186.21 Typical High $2,344.23 | Professional | 52 · Reduced service | $186.21 | $186.21 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $933.25 | Professional | 53 · Discontinued | $74.13 | $74.13 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $3,548.13 | Professional | 54 · Surgery only | $275.42 | $275.42 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $707.95 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $467.74 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $467.74 |
Where Washington, DC sits
The same service costs 15.5 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· 39th of 51
$3,162
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.