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 $33.88 Median $1,698.24 Typical High $4,073.80 | Facility | None | $33.88 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $36.31 | Professional | None | $25.70 | $33.88 | $36.31 |
CareFirst Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $630.96 | Professional | None | $26.30 | $28.84 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $77.62 | Professional | None | $24.55 | $26.92 | $77.62 |
Kaiser Permanente Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $64.57 | Professional | None | $30.90 | $35.48 | $64.57 |
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 $21.38 Median $27.54 Typical High $79.43 | Professional | None | $21.38 | $27.54 | $79.43 |
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 $14.13 Median $16.98 Typical High $18.20 | Professional | 52 · Reduced service | $14.13 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $6.92 Typical High $7.24 | Professional | 53 · Discontinued | $5.62 | $6.92 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $25.70 Typical High $27.54 | Professional | 54 · Surgery only | $21.38 | $25.70 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.13 Typical High $5.50 | Professional | 55 · Aftercare only | $4.27 | $5.13 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.39 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.82 | $3.39 | $3.63 |
Where Washington, DC sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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
$30.90
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.