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 $134.90 Median $1,862.09 Typical High $4,073.80 | Facility | None | $134.90 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | None | $125.89 | $134.90 | $134.90 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | None | $109.65 | $120.23 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $251.19 | Professional | None | $112.20 | $123.03 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $263.03 | Professional | None | $102.33 | $114.82 | $263.03 |
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 $95.50 Median $112.20 Typical High $295.12 | Professional | None | $95.50 | $112.20 | $295.12 |
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 $63.10 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $25.12 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 54 · Surgery only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $13.49 |
Where Washington, DC sits
The same service costs 4.8 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· 41st of 51
$120
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.