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 $323.59 Median $3,548.13 Typical High $4,786.30 | Facility | None | $323.59 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | None | $295.12 | $323.59 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $371.54 | Professional | None | $269.15 | $302.00 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $549.54 | Professional | None | $269.15 | $288.40 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $630.96 | Professional | None | $229.09 | $257.04 | $630.96 |
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 $239.88 Median $269.15 Typical High $707.95 | Professional | None | $239.88 | $269.15 | $707.95 |
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 $154.88 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $61.66 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $229.09 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $30.90 | $32.36 | $32.36 |
Where Washington, DC sits
The same service costs 4.3 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· 41st of 51
$302
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.