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 $128.82 Median $1,862.09 Typical High $4,073.80 | Facility | None | $128.82 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $131.83 | Professional | None | $125.89 | $128.82 | $131.83 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $147.91 | Professional | None | $112.20 | $123.03 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $239.88 | Professional | None | $112.20 | $117.49 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $251.19 | Professional | None | $93.33 | $102.33 | $251.19 |
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 $102.33 Median $114.82 Typical High $281.84 | Professional | None | $102.33 | $114.82 | $281.84 |
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 $64.57 Typical High $66.07 | Professional | 52 · Reduced service | $63.10 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.70 Typical High $26.30 | Professional | 53 · Discontinued | $25.12 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $97.72 Typical High $100.00 | Professional | 54 · Surgery only | $95.50 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.50 Typical High $19.95 | Professional | 55 · Aftercare only | $19.05 | $19.50 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.88 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.59 | $12.88 | $13.18 |
Where Washington, DC sits
The same service costs 4.7 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· 43rd of 51
$123
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.