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 $138.04 Median $1,698.24 Typical High $7,943.28 | Facility | None | $138.04 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | None | $120.23 | $138.04 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $131.83 | Professional | None | $114.82 | $128.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $229.09 | Professional | None | $114.82 | $123.03 | $229.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $263.03 | Professional | None | $97.72 | $109.65 | $263.03 |
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 $93.33 Median $114.82 Typical High $295.12 | Professional | None | $93.33 | $114.82 | $295.12 |
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 $64.57 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $25.70 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $19.05 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $12.88 | $13.80 | $13.80 |
Where Washington, DC sits
The same service costs 4.3 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
$129
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.