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 $85.11 Median $1,548.82 Typical High $3,311.31 | Facility | None | $85.11 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $144.54 Typical High $354.81 | Professional | None | $85.11 | $144.54 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $1,380.38 | Professional | None | $83.18 | $91.20 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $371.54 | Professional | None | $77.62 | $134.90 | $371.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $323.59 | Professional | None | $165.96 | $194.98 | $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 $79.43 Median $165.96 Typical High $346.74 | Professional | None | $79.43 | $165.96 | $346.74 |
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 $42.66 Median $67.61 Typical High $72.44 | Professional | 52 · Reduced service | $42.66 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $26.92 Typical High $28.84 | Professional | 53 · Discontinued | $16.98 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $63.10 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $12.59 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.51 | $13.49 | $14.45 |
Where Washington, DC sits
The same service costs 4.2 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· 36th of 51
$145
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.