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 $275.42 Median $1,698.24 Typical High $7,943.28 | Facility | None | $275.42 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | None | $245.47 | $275.42 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $288.40 | Professional | None | $229.09 | $257.04 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $457.09 | Professional | None | $229.09 | $245.47 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $537.03 | Professional | None | $199.53 | $223.87 | $537.03 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,412.54 Typical High $6,309.57 | Facility | None | $426.58 | $1,412.54 | $6,309.57 |
United Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $602.56 | Professional | None | $186.21 | $229.09 | $602.56 |
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 $128.82 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $51.29 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $38.90 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $25.70 | $27.54 | $27.54 |
Where Washington, DC sits
The same service costs 4.1 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· 38th of 51
$257
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.