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 $177.83 Median $1,548.82 Typical High $3,311.31 | Facility | None | $177.83 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $380.19 | Professional | None | $173.78 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $81.28 Typical High $190.55 | Professional | 53 · Discontinued | $35.48 | $81.28 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $204.17 | Professional | None | $151.36 | $165.96 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $457.09 | Professional | None | $158.49 | $302.00 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $741.31 | Professional | None | $346.74 | $380.19 | $741.31 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $380.19 Typical High $741.31 | Professional | 53 · Discontinued | $346.74 | $380.19 | $741.31 |
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 $138.04 Median $275.42 Typical High $501.19 | Professional | None | $138.04 | $275.42 | $501.19 |
4 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 $89.13 Median $147.91 Typical High $190.55 | Professional | 52 · Reduced service | $89.13 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $288.40 | Professional | 54 · Surgery only | $134.90 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $26.92 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $17.78 | $28.84 | $38.02 |
Where Washington, DC sits
The same service costs 3.6 times more in Alaska than in Washington, DC. 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· 51st of 51
$191
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.