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 $977.24 Median $3,981.07 Typical High $13,182.57 | Facility | None | $977.24 | $3,981.07 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $1,288.25 Typical High $12,589.25 | Professional | None | $524.81 | $1,288.25 | $12,589.25 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $12,589.25 | Professional | None | $398.11 | $436.52 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,412.54 Typical High $12,302.69 | Professional | None | $389.05 | $1,412.54 | $12,302.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $10,232.93 Typical High $11,220.18 | Professional | None | $954.99 | $10,232.93 | $11,220.18 |
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 $457.09 Median $1,288.25 Typical High $14,791.08 | Professional | None | $457.09 | $1,288.25 | $14,791.08 |
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 $263.03 Median $263.03 Typical High $3,162.28 | Professional | 52 · Reduced service | $263.03 | $263.03 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $1,288.25 | Professional | 53 · Discontinued | $104.71 | $104.71 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $4,786.30 | Professional | 54 · Surgery only | $389.05 | $389.05 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $954.99 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $630.96 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $630.96 |
Where Washington, DC sits
The same service costs 10.2 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· 43rd of 51
$3,388
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.