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 $123.03 Median $3,548.13 Typical High $4,786.30 | Facility | None | $123.03 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | None | $107.15 | $123.03 | $123.03 |
CareFirst Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $125.89 | Professional | None | $97.72 | $109.65 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $194.98 | Professional | None | $104.71 | $109.65 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $234.42 | Professional | None | $89.13 | $97.72 | $234.42 |
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 $83.18 Median $102.33 Typical High $263.03 | Professional | None | $83.18 | $102.33 | $263.03 |
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 $57.54 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $22.91 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $85.11 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $12.30 |
Where Washington, DC sits
The same service costs 4.6 times more in Alaska than in New Jersey. 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
$110
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.