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 $309.03 Median $3,388.44 Typical High $6,606.93 | Facility | None | $309.03 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $346.74 | Professional | None | $302.00 | $309.03 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $354.81 | Professional | None | $263.03 | $288.40 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $575.44 | Professional | None | $269.15 | $275.42 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $616.60 | Professional | None | $229.09 | $257.04 | $616.60 |
United Setting Facility Modifier None Typical Low $2,754.23 Median $5,128.61 Typical High $42,657.95 | Facility | None | $2,754.23 | $5,128.61 | $42,657.95 |
United Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $676.08 | Professional | None | $251.19 | $275.42 | $676.08 |
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 $151.36 Median $154.88 Typical High $154.88 | Professional | 52 · Reduced service | $151.36 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | 53 · Discontinued | $60.26 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 56 · Pre-op care only | $30.20 | $30.90 | $30.90 |
Where Washington, DC sits
The same service costs 4.2 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· 47th of 51
$288
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.