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 $95.50 Median $1,698.24 Typical High $4,073.80 | Facility | None | $95.50 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $218.78 Typical High $478.63 | Professional | None | $93.33 | $218.78 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $1,380.38 | Professional | None | $93.33 | $104.71 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $199.53 Typical High $616.60 | Professional | None | $83.18 | $199.53 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $549.54 | Professional | None | $218.78 | $269.15 | $549.54 |
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 $81.28 Median $204.17 Typical High $588.84 | Professional | None | $81.28 | $204.17 | $588.84 |
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 $47.86 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $47.86 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $19.05 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $70.79 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $14.13 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.55 | $20.89 | $24.55 |
Where Washington, DC sits
The same service costs 4.5 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· 26th of 51
$200
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.