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 $190.55 Median $1,698.24 Typical High $7,943.28 | Facility | None | $190.55 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $190.55 Typical High $213.80 | Professional | None | $186.21 | $190.55 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $269.15 | Professional | None | $204.17 | $223.87 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $512.86 | Professional | None | $173.78 | $173.78 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $177.83 Median $398.11 Typical High $446.68 | Professional | None | $177.83 | $398.11 | $446.68 |
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 $151.36 Median $257.04 Typical High $524.81 | Professional | None | $151.36 | $257.04 | $524.81 |
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 $93.33 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $93.33 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $37.15 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $144.54 Typical High $162.18 | Professional | 54 · Surgery only | $141.25 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.84 Typical High $32.36 | Professional | 55 · Aftercare only | $28.18 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $18.62 | $19.05 | $21.38 |
Where Washington, DC sits
The same service costs 4.8 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
$224
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.