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 $691.83 Median $3,548.13 Typical High $4,786.30 | Facility | None | $691.83 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $1,737.80 | Professional | None | $660.69 | $691.83 | $1,737.80 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,071.52 | Professional | None | $630.96 | $741.31 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $1,819.70 | Professional | None | $630.96 | $660.69 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $602.56 Median $1,412.54 Typical High $1,584.89 | Professional | None | $602.56 | $1,412.54 | $1,584.89 |
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 $562.34 Median $933.25 Typical High $1,862.09 | Professional | None | $562.34 | $933.25 | $1,862.09 |
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 $331.13 Median $346.74 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $77.62 |
Where Washington, DC sits
The same service costs 4.7 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· 39th of 51
$741
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.