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 $295.12 Median $3,090.30 Typical High $6,606.93 | Facility | None | $295.12 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $302.00 | Professional | None | $275.42 | $295.12 | $302.00 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | None | $251.19 | $275.42 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $501.19 | Professional | None | $245.47 | $269.15 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $575.44 | Professional | None | $213.80 | $239.88 | $575.44 |
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 $208.93 Median $245.47 Typical High $645.65 | Professional | None | $208.93 | $245.47 | $645.65 |
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 $141.25 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $57.54 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 54 · Surgery only | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $29.51 |
Where Washington, DC sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 43rd of 51
$275
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.