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 $223.87 Median $2,818.38 Typical High $4,786.30 | Facility | None | $223.87 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $245.47 | Professional | None | $213.80 | $223.87 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $239.88 | Professional | None | $186.21 | $208.93 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $199.53 Typical High $416.87 | Professional | None | $190.55 | $199.53 | $416.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $436.52 | Professional | None | $162.18 | $177.83 | $436.52 |
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 $173.78 Median $194.98 Typical High $489.78 | Professional | None | $173.78 | $194.98 | $489.78 |
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 $107.15 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $32.36 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $21.38 | $22.39 | $22.39 |
Where Washington, DC sits
The same service costs 5.9 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· 44th of 51
$209
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.