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 $45.71 Median $3,548.13 Typical High $4,786.30 | Facility | None | $45.71 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | None | $41.69 | $45.71 | $45.71 |
CareFirst Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $45.71 | Professional | None | $36.31 | $39.81 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $40.74 Typical High $75.86 | Professional | None | $38.02 | $40.74 | $75.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $35.48 Typical High $87.10 | Professional | None | $31.62 | $35.48 | $87.10 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $97.72 | Professional | None | $32.36 | $38.02 | $97.72 |
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 $21.88 Median $22.91 Typical High $22.91 | Professional | 52 · Reduced service | $21.88 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $9.12 Typical High $9.12 | Professional | 53 · Discontinued | $8.71 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 54 · Surgery only | $32.36 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.92 Typical High $6.92 | Professional | 55 · Aftercare only | $6.76 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 56 · Pre-op care only | $4.47 | $4.57 | $4.57 |
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· 46th of 51
$40.74
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.