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 $245.47 Median $1,862.09 Typical High $4,073.80 | Facility | None | $245.47 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $269.15 | Professional | None | $234.42 | $245.47 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $630.96 | Professional | None | $239.88 | $263.03 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $645.65 | Professional | None | $223.87 | $239.88 | $645.65 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $512.86 Typical High $562.34 | Professional | None | $218.78 | $512.86 | $562.34 |
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 $208.93 Median $338.84 Typical High $676.08 | Professional | None | $208.93 | $338.84 | $676.08 |
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 $120.23 Median $123.03 Typical High $141.25 | Professional | 52 · Reduced service | $120.23 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $50.12 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $24.55 | $28.18 |
Where Washington, DC sits
The same service costs 5.0 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
$263
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.