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 $467.74 Median $3,981.07 Typical High $7,413.10 | Facility | None | $467.74 | $3,981.07 | $7,413.10 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | None | $446.68 | $467.74 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $501.19 | Professional | None | $389.05 | $426.58 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $794.33 | Professional | None | $389.05 | $416.87 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $912.01 | Professional | None | $331.13 | $371.54 | $912.01 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $1,023.29 | Professional | None | $346.74 | $380.19 | $1,023.29 |
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 $223.87 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $223.87 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $46.77 |
Where Washington, DC sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 44th of 51
$427
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.