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 $363.08 Median $2,818.38 Typical High $4,786.30 | Facility | None | $363.08 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $380.19 | Professional | None | $331.13 | $363.08 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $416.87 | Professional | None | $309.03 | $338.84 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $616.60 | Professional | None | $309.03 | $323.59 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $707.95 | Professional | None | $263.03 | $288.40 | $707.95 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $794.33 | Professional | None | $275.42 | $302.00 | $794.33 |
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 $173.78 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $173.78 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $69.18 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $263.03 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $36.31 |
Where Washington, DC sits
The same service costs 4.5 times more in Alaska than in New York. 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
$339
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.