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 $87.10 Median $1,698.24 Typical High $4,073.80 | Facility | None | $87.10 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $346.74 | Professional | None | $87.10 | $141.25 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $1,380.38 | Professional | None | $87.10 | $95.50 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $371.54 | Professional | None | $79.43 | $128.82 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $323.59 | Professional | None | $165.96 | $199.53 | $323.59 |
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 $81.28 Median $162.18 Typical High $338.84 | Professional | None | $81.28 | $162.18 | $338.84 |
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 $43.65 Median $67.61 Typical High $70.79 | Professional | 52 · Reduced service | $43.65 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $26.92 Typical High $28.18 | Professional | 53 · Discontinued | $17.38 | $26.92 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $66.07 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $13.18 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.49 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.71 | $13.49 | $14.13 |
Where Washington, DC sits
The same service costs 4.3 times more in Alaska than in Virginia. 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
$141
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.