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 $181.97 Median $1,862.09 Typical High $4,073.80 | Facility | None | $181.97 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $181.97 Typical High $436.52 | Professional | None | $169.82 | $181.97 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $181.97 Median $199.53 Typical High $630.96 | Professional | None | $181.97 | $199.53 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $165.96 Typical High $467.74 | Professional | None | $162.18 | $165.96 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $371.54 Typical High $416.87 | Professional | None | $151.36 | $371.54 | $416.87 |
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 $144.54 Median $245.47 Typical High $489.78 | Professional | None | $144.54 | $245.47 | $489.78 |
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 $87.10 Median $89.13 Typical High $102.33 | Professional | 52 · Reduced service | $87.10 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $36.31 Typical High $40.74 | Professional | 53 · Discontinued | $34.67 | $36.31 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $134.90 Typical High $151.36 | Professional | 54 · Surgery only | $128.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $25.70 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $18.20 | $20.42 |
Where Washington, DC sits
The same service costs 5.5 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· 40th 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.