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 $194.98 Median $1,862.09 Typical High $4,073.80 | Facility | None | $194.98 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | None | $177.83 | $194.98 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $213.80 | Professional | None | $165.96 | $186.21 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $346.74 | Professional | None | $165.96 | $177.83 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $346.74 | Professional | None | $138.04 | $154.88 | $346.74 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $426.58 | Professional | None | $138.04 | $162.18 | $426.58 |
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 $93.33 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $37.15 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $28.18 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $18.62 | $19.50 | $19.50 |
Where Washington, DC sits
The same service costs 5.2 times more in Alaska than in Utah. 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
$186
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.