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 $109.65 Median $1,698.24 Typical High $4,073.80 | Facility | None | $109.65 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $269.15 Typical High $676.08 | Professional | None | $109.65 | $269.15 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $1,380.38 | Professional | None | $107.15 | $120.23 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $213.80 Typical High $660.69 | Professional | None | $91.20 | $213.80 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $602.56 | Professional | None | $251.19 | $302.00 | $602.56 |
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 $234.42 Typical High $630.96 | Professional | None | $100.00 | $234.42 | $630.96 |
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 $54.95 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $54.95 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $21.88 | $46.77 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $177.83 Typical High $199.53 | Professional | 54 · Surgery only | $83.18 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $16.60 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $10.96 | $23.44 | $26.92 |
Where Washington, DC sits
The same service costs 4.5 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· 27th of 51
$229
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.