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 $112.20 Median $1,548.82 Typical High $3,311.31 | Facility | None | $112.20 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $338.84 | Professional | None | $112.20 | $173.78 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $123.03 Typical High $1,380.38 | Professional | None | $112.20 | $123.03 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $457.09 | Professional | None | $100.00 | $158.49 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $398.11 | Professional | None | $181.97 | $257.04 | $398.11 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $416.87 | Professional | None | $100.00 | $194.98 | $416.87 |
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 $56.23 Median $81.28 Typical High $87.10 | Professional | 52 · Reduced service | $56.23 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $32.36 Typical High $34.67 | Professional | 53 · Discontinued | $22.39 | $32.36 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $123.03 Typical High $131.83 | Professional | 54 · Surgery only | $83.18 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $24.55 Typical High $26.30 | Professional | 55 · Aftercare only | $16.98 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.22 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.22 | $16.22 | $17.38 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 38th of 51
$166
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.