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 $1,071.52 Median $3,981.07 Typical High $20,417.38 | Facility | None | $1,071.52 | $3,981.07 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $1,445.44 Typical High $19,054.61 | Professional | None | $575.44 | $1,445.44 | $19,054.61 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $15,488.17 | Professional | None | $436.52 | $489.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,548.82 Typical High $19,054.61 | Professional | None | $436.52 | $1,548.82 | $19,054.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $15,848.93 Typical High $16,982.44 | Professional | None | $1,047.13 | $15,848.93 | $16,982.44 |
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 $489.78 Median $1,445.44 Typical High $22,908.68 | Professional | None | $489.78 | $1,445.44 | $22,908.68 |
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 $288.40 Median $288.40 Typical High $4,897.79 | Professional | 52 · Reduced service | $288.40 | $288.40 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $1,949.84 | Professional | 53 · Discontinued | $114.82 | $114.82 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $7,244.36 | Professional | 54 · Surgery only | $436.52 | $436.52 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $1,479.11 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $977.24 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $977.24 |
Where Washington, DC sits
The same service costs 12.6 times more in Oregon 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· 45th 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.