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 $257.04 Median $1,862.09 Typical High $4,073.80 | Facility | None | $257.04 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $295.12 | Professional | None | $251.19 | $257.04 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $1,380.38 | Professional | None | $234.42 | $263.03 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $676.08 | Professional | None | $234.42 | $281.84 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $537.03 Typical High $588.84 | Professional | None | $229.09 | $537.03 | $588.84 |
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 $223.87 Median $389.05 Typical High $691.83 | Professional | None | $223.87 | $389.05 | $691.83 |
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 $125.89 Median $128.82 Typical High $147.91 | Professional | 52 · Reduced service | $125.89 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $50.12 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $223.87 | Professional | 54 · Surgery only | $190.55 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $44.67 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $29.51 |
Where Washington, DC sits
The same service costs 5.0 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
$282
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.