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 $213.80 Median $1,862.09 Typical High $4,073.80 | Facility | None | $213.80 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $245.47 | Professional | None | $199.53 | $213.80 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | None | $223.87 | $251.19 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $512.86 | Professional | None | $177.83 | $194.98 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $436.52 Typical High $446.68 | Professional | None | $173.78 | $436.52 | $446.68 |
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 $186.21 Median $295.12 Typical High $537.03 | Professional | None | $186.21 | $295.12 | $537.03 |
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 $100.00 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $100.00 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $39.81 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $162.18 Typical High $173.78 | Professional | 54 · Surgery only | $151.36 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.95 | $21.38 | $24.55 |
Where Washington, DC sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 33rd of 51
$245
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.