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 $269.15 Median $3,548.13 Typical High $4,786.30 | Facility | None | $269.15 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | None | $257.04 | $269.15 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $288.40 | Professional | None | $223.87 | $245.47 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $457.09 | Professional | None | $223.87 | $239.88 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $478.63 | Professional | None | $190.55 | $213.80 | $478.63 |
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 $186.21 Median $223.87 Typical High $575.44 | Professional | None | $186.21 | $223.87 | $575.44 |
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 $128.82 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $128.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $51.29 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $26.92 |
Where Washington, DC sits
The same service costs 4.8 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· 42nd of 51
$245
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.