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 $524.81 Median $3,090.30 Typical High $6,606.93 | Facility | None | $524.81 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $549.54 | Professional | None | $478.63 | $524.81 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $562.34 | Professional | None | $436.52 | $489.78 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $891.25 | Professional | None | $436.52 | $467.74 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $1,023.29 | Professional | None | $371.54 | $416.87 | $1,023.29 |
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 $363.08 Median $436.52 Typical High $1,148.15 | Professional | None | $363.08 | $436.52 | $1,148.15 |
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 $251.19 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $100.00 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $371.54 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $52.48 |
Where Washington, DC sits
The same service costs 4.7 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· 41st of 51
$490
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.