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 $186.21 Median $1,548.82 Typical High $3,311.31 | Facility | None | $186.21 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $457.09 | Professional | None | $117.49 | $186.21 | $457.09 |
CareFirst Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $1,380.38 | Professional | None | $109.65 | $123.03 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $489.78 | Professional | None | $102.33 | $169.82 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $426.58 | Professional | None | $204.17 | $269.15 | $426.58 |
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 $109.65 Median $199.53 Typical High $457.09 | Professional | None | $109.65 | $199.53 | $457.09 |
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 $58.88 Median $81.28 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $89.13 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $17.78 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $16.60 | $18.62 |
Where Washington, DC sits
The same service costs 3.3 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· 38th of 51
$174
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.