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 $363.08 Median $1,698.24 Typical High $4,073.80 | Facility | None | $363.08 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $870.96 | Professional | None | $354.81 | $363.08 | $870.96 |
CareFirst Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $630.96 | Professional | None | $346.74 | $389.05 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $954.99 | Professional | None | $316.23 | $331.13 | $954.99 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $831.76 | Professional | None | $323.59 | $741.31 | $831.76 |
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 $295.12 Median $489.78 Typical High $1,000.00 | Professional | None | $295.12 | $489.78 | $1,000.00 |
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 $177.83 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $177.83 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $70.79 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $35.48 | $36.31 | $41.69 |
Where Washington, DC sits
The same service costs 4.9 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· 41st of 51
$389
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.