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 $208.93 Median $1,698.24 Typical High $7,943.28 | Facility | None | $208.93 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $234.42 | Professional | None | $194.98 | $208.93 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $275.42 | Professional | None | $204.17 | $229.09 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $549.54 | Professional | None | $173.78 | $190.55 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $478.63 | Professional | None | $194.98 | $436.52 | $478.63 |
United Setting Facility Modifier None Typical Low $426.58 Median $1,412.54 Typical High $6,309.57 | Facility | None | $426.58 | $1,412.54 | $6,309.57 |
United Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $575.44 | Professional | None | $158.49 | $281.84 | $575.44 |
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 $97.72 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $97.72 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $38.90 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $158.49 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $29.51 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $23.44 |
Where Washington, DC sits
The same service costs 5.1 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· 41st 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.