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 $66.07 Median $2,818.38 Typical High $4,786.30 | Facility | None | $66.07 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $144.54 Typical High $354.81 | Professional | None | $66.07 | $144.54 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $549.54 | Professional | None | $66.07 | $72.44 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $120.23 Typical High $346.74 | Professional | None | $53.70 | $120.23 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $323.59 | Professional | None | $154.88 | $169.82 | $323.59 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $66.07 Median $144.54 Typical High $346.74 | Professional | None | $66.07 | $144.54 | $346.74 |
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 $33.11 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $33.11 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $13.18 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $50.12 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $10.00 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.61 | $12.30 | $14.45 |
Where Washington, DC sits
The same service costs 3.8 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· 28th of 51
$135
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.