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 $75.86 Median $1,862.09 Typical High $4,073.80 | Facility | None | $75.86 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $190.55 | Professional | None | $74.13 | $75.86 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $1,584.89 | Professional | None | $74.13 | $81.28 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $204.17 | Professional | None | $69.18 | $70.79 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $173.78 | Professional | None | $74.13 | $154.88 | $173.78 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $57.54 Median $104.71 Typical High $204.17 | Professional | None | $57.54 | $104.71 | $204.17 |
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 $37.15 Median $38.02 Typical High $43.65 | Professional | 52 · Reduced service | $37.15 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $17.38 | Professional | 53 · Discontinued | $14.79 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $57.54 Typical High $64.57 | Professional | 54 · Surgery only | $56.23 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $8.71 |
Where Washington, DC sits
The same service costs 4.7 times more in Alaska than in New York. 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· 48th of 51
$81.28
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.