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 $436.52 Median $3,548.13 Typical High $4,786.30 | Facility | None | $436.52 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $446.68 | Professional | None | $426.58 | $436.52 | $446.68 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $501.19 | Professional | None | $363.08 | $407.38 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $389.05 Typical High $741.31 | Professional | None | $371.54 | $389.05 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $851.14 | Professional | None | $309.03 | $346.74 | $851.14 |
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 $331.13 Median $363.08 Typical High $954.99 | Professional | None | $331.13 | $363.08 | $954.99 |
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 $208.93 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $43.65 |
Where Washington, DC sits
The same service costs 4.6 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· 40th of 51
$407
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.