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 $363.08 Median $3,388.44 Typical High $6,606.93 | Facility | None | $363.08 | $3,388.44 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | None | $363.08 | $363.08 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $380.19 | Professional | None | $295.12 | $323.59 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $676.08 | Professional | None | $316.23 | $331.13 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $707.95 | Professional | None | $275.42 | $302.00 | $707.95 |
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 $302.00 Median $331.13 Typical High $794.33 | Professional | None | $302.00 | $331.13 | $794.33 |
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 $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $72.44 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $275.42 | Professional | 54 · Surgery only | $269.15 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $36.31 |
Where Washington, DC sits
The same service costs 4.5 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· 45th of 51
$331
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.