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 $194.98 Median $1,698.24 Typical High $4,073.80 | Facility | None | $194.98 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $208.93 | Professional | None | $190.55 | $194.98 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $234.42 | Professional | None | $162.18 | $181.97 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $363.08 | Professional | None | $165.96 | $173.78 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $380.19 | Professional | None | $141.25 | $158.49 | $380.19 |
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 $158.49 Median $190.55 Typical High $426.58 | Professional | None | $158.49 | $190.55 | $426.58 |
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 $95.50 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $95.50 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $38.02 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $141.25 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $28.18 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $19.50 |
Where Washington, DC sits
The same service costs 5.1 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· 44th of 51
$182
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.