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 $676.08 Median $3,801.89 Typical High $10,232.93 | Facility | None | $676.08 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $891.25 Typical High $3,630.78 | Professional | None | $363.08 | $891.25 | $3,630.78 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $10,715.19 | Professional | None | $275.42 | $309.03 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $954.99 Typical High $3,548.13 | Professional | None | $269.15 | $954.99 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $660.69 Median $3,162.28 Typical High $3,235.94 | Professional | None | $660.69 | $3,162.28 | $3,235.94 |
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 $309.03 Median $891.25 Typical High $4,365.16 | Professional | None | $309.03 | $891.25 | $4,365.16 |
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 $177.83 Median $177.83 Typical High $912.01 | Professional | 52 · Reduced service | $177.83 | $177.83 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $363.08 | Professional | 53 · Discontinued | $72.44 | $72.44 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $1,380.38 | Professional | 54 · Surgery only | $269.15 | $269.15 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $275.42 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $181.97 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $181.97 |
Where Washington, DC sits
The same service costs 6.0 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· 44th of 51
$1,288
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.