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 $2,818.38 Typical High $4,786.30 | Facility | None | $407.38 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $501.19 | Professional | None | $398.11 | $407.38 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $549.54 | Professional | None | $346.74 | $380.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $758.58 | Professional | None | $346.74 | $371.54 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $794.33 | Professional | None | $295.12 | $331.13 | $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 $338.84 Median $407.38 Typical High $891.25 | Professional | None | $338.84 | $407.38 | $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 $199.53 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $199.53 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $79.43 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $309.03 Typical High $316.23 | Professional | 54 · Surgery only | $302.00 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $63.10 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $41.69 |
Where Washington, DC sits
The same service costs 4.9 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· 46th 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.