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 $128.82 Median $2,818.38 Typical High $4,786.30 | Facility | None | $128.82 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $186.21 | Professional | None | $120.23 | $128.82 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $2,089.30 | Professional | None | $102.33 | $112.20 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $389.05 | Professional | None | $95.50 | $134.90 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $331.13 | Professional | None | $154.88 | $177.83 | $331.13 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $363.08 | Professional | None | $81.28 | $134.90 | $363.08 |
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 $60.26 Median $64.57 Typical High $91.20 | Professional | 52 · Reduced service | $60.26 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.70 Typical High $37.15 | Professional | 53 · Discontinued | $23.99 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $95.50 Typical High $138.04 | Professional | 54 · Surgery only | $91.20 | $95.50 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $27.54 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.88 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.02 | $12.88 | $18.62 |
Where Washington, DC sits
The same service costs 4.7 times more in Alaska than in Delaware. 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· 48th of 51
$129
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.