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 $204.17 Median $3,548.13 Typical High $4,786.30 | Facility | None | $204.17 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | None | $199.53 | $204.17 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $229.09 | Professional | None | $165.96 | $181.97 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $389.05 | Professional | None | $173.78 | $186.21 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $407.38 | Professional | None | $147.91 | $165.96 | $407.38 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $457.09 | Professional | None | $158.49 | $169.82 | $457.09 |
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 $100.00 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $100.00 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $39.81 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $154.88 Typical High $154.88 | Professional | 54 · Surgery only | $147.91 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $19.95 | $20.42 | $20.42 |
Where Washington, DC sits
The same service costs 5.5 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· 42nd of 51
$186
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.