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 $213.80 Median $3,548.13 Typical High $4,786.30 | Facility | None | $213.80 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $218.78 | Professional | None | $194.98 | $213.80 | $218.78 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | None | $181.97 | $199.53 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $371.54 | Professional | None | $181.97 | $194.98 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $389.05 | Professional | None | $158.49 | $173.78 | $389.05 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $467.74 | Professional | None | $151.36 | $177.83 | $467.74 |
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 $102.33 Median $107.15 Typical High $107.15 | Professional | 52 · Reduced service | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $40.74 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $20.42 | $21.38 | $21.38 |
Where Washington, DC sits
The same service costs 4.7 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· 40th of 51
$200
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.