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 $269.15 Median $3,548.13 Typical High $4,786.30 | Facility | None | $269.15 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $275.42 | Professional | None | $245.47 | $269.15 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $302.00 | Professional | None | $218.78 | $239.88 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $457.09 | Professional | None | $234.42 | $245.47 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $524.81 | Professional | None | $194.98 | $218.78 | $524.81 |
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 $204.17 Median $223.87 Typical High $588.84 | Professional | None | $204.17 | $223.87 | $588.84 |
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 $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $51.29 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $26.92 |
Where Washington, DC sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 43rd of 51
$245
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.