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 $616.60 Median $1,862.09 Typical High $4,073.80 | Facility | None | $616.60 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $676.08 | Professional | None | $602.56 | $616.60 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $645.65 | Professional | None | $537.03 | $602.56 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $1,659.59 | Professional | None | $537.03 | $562.34 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $1,258.93 Typical High $1,412.54 | Professional | None | $616.60 | $1,258.93 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $218.78 Median $758.58 Typical High $1,737.80 | Professional | None | $218.78 | $758.58 | $1,737.80 |
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 $295.12 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $67.61 |
Where Washington, DC sits
The same service costs 10.0 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· 30th of 51
$617
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.