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 $218.78 Median $3,548.13 Typical High $4,786.30 | Facility | None | $218.78 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $218.78 Typical High $245.47 | Professional | None | $208.93 | $218.78 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $630.96 | Professional | None | $208.93 | $229.09 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $575.44 | Professional | None | $194.98 | $194.98 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $446.68 Typical High $489.78 | Professional | None | $190.55 | $446.68 | $489.78 |
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 $173.78 Median $295.12 Typical High $588.84 | Professional | None | $173.78 | $295.12 | $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 $104.71 Median $107.15 Typical High $123.03 | Professional | 52 · Reduced service | $104.71 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $41.69 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $162.18 Typical High $181.97 | Professional | 54 · Surgery only | $158.49 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $36.31 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $24.55 |
Where Washington, DC sits
The same service costs 4.5 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· 42nd of 51
$229
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.