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 $794.33 Median $3,981.07 Typical High $9,120.11 | Facility | None | $794.33 | $3,981.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,995.26 Typical High $17,378.01 | Professional | None | $794.33 | $1,995.26 | $17,378.01 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $15,488.17 | Professional | None | $645.65 | $724.44 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $2,137.96 Typical High $17,378.01 | Professional | None | $602.56 | $2,137.96 | $17,378.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $14,791.08 Typical High $15,848.93 | Professional | None | $1,445.44 | $14,791.08 | $15,848.93 |
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 $676.08 Median $1,995.26 Typical High $20,892.96 | Professional | None | $676.08 | $1,995.26 | $20,892.96 |
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 $398.11 Median $398.11 Typical High $4,466.84 | Professional | 52 · Reduced service | $398.11 | $398.11 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $1,819.70 | Professional | 53 · Discontinued | $158.49 | $158.49 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $6,760.83 | Professional | 54 · Surgery only | $602.56 | $602.56 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $1,348.96 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $912.01 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $912.01 |
Where Washington, DC sits
The same service costs 8.7 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· 42nd 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.