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 $407.38 Median $3,548.13 Typical High $4,786.30 | Facility | None | $407.38 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | None | $389.05 | $407.38 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $467.74 | Professional | None | $338.84 | $380.19 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $363.08 Typical High $691.83 | Professional | None | $346.74 | $363.08 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $794.33 | Professional | None | $288.40 | $323.59 | $794.33 |
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 $316.23 Median $354.81 Typical High $891.25 | Professional | None | $316.23 | $354.81 | $891.25 |
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 $194.98 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $77.62 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $295.12 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $58.88 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $40.74 |
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
$380
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.