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 $1,698.24 Typical High $4,073.80 | Facility | None | $54.95 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $117.49 Typical High $229.09 | Professional | None | $54.95 | $117.49 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $1,584.89 | Professional | None | $53.70 | $58.88 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $302.00 | Professional | None | $50.12 | $123.03 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $281.84 | Professional | None | $125.89 | $138.04 | $281.84 |
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 $69.18 Median $125.89 Typical High $281.84 | Professional | None | $69.18 | $125.89 | $281.84 |
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 $53.70 Typical High $58.88 | Professional | 52 · Reduced service | $27.54 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $21.38 Typical High $23.44 | Professional | 53 · Discontinued | $10.96 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $79.43 Typical High $87.10 | Professional | 54 · Surgery only | $40.74 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $15.85 Typical High $17.38 | Professional | 55 · Aftercare only | $8.13 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $10.72 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.50 | $10.72 | $11.75 |
Where Washington, DC sits
The same service costs 3.2 times more in Alaska than in Virginia. 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· 31st of 51
$115
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.