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 $302.00 Median $1,698.24 Typical High $7,943.28 | Facility | None | $302.00 | $1,698.24 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $331.13 | Professional | None | $288.40 | $302.00 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $371.54 | Professional | None | $263.03 | $338.84 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $776.25 | Professional | None | $263.03 | $269.15 | $776.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $275.42 Median $602.56 Typical High $676.08 | Professional | None | $275.42 | $602.56 | $676.08 |
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 $234.42 Median $398.11 Typical High $812.83 | Professional | None | $234.42 | $398.11 | $812.83 |
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 $144.54 Median $151.36 Typical High $165.96 | Professional | 52 · Reduced service | $144.54 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $60.26 Typical High $66.07 | Professional | 53 · Discontinued | $58.88 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $33.11 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $33.11 |
Where Washington, DC sits
The same service costs 4.2 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· 43rd of 51
$309
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.