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 $245.47 Median $4,073.80 Typical High $7,079.46 | Facility | None | $245.47 | $4,073.80 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $245.47 Typical High $275.42 | Professional | None | $239.88 | $245.47 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $630.96 | Professional | None | $251.19 | $275.42 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $645.65 | Professional | None | $223.87 | $229.09 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $512.86 Typical High $562.34 | Professional | None | $223.87 | $512.86 | $562.34 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $660.69 | Professional | None | $199.53 | $331.13 | $660.69 |
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 $120.23 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $47.86 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $27.54 |
Where Washington, DC sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 39th of 51
$275
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.