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 $54.95 Median $1,548.82 Typical High $3,311.31 | Facility | None | $54.95 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $89.13 Typical High $165.96 | Professional | None | $54.95 | $89.13 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $1,584.89 | Professional | None | $53.70 | $60.26 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $97.72 Typical High $234.42 | Professional | None | $50.12 | $97.72 | $234.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $204.17 | Professional | None | $95.50 | $125.89 | $204.17 |
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 $112.20 Typical High $229.09 | Professional | None | $57.54 | $112.20 | $229.09 |
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 $27.54 Median $42.66 Typical High $44.67 | Professional | 52 · Reduced service | $27.54 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $10.96 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $63.10 Typical High $67.61 | Professional | 54 · Surgery only | $41.69 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $8.32 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.51 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.50 | $8.51 | $8.91 |
Where Washington, DC sits
The same service costs 3.2 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· 39th of 51
$89.13
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.