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 $79.43 Median $1,412.54 Typical High $7,943.28 | Facility | None | $79.43 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $97.72 | Professional | None | $63.10 | $79.43 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $1,380.38 | Professional | None | $61.66 | $69.18 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $251.19 | Professional | None | $58.88 | $70.79 | $251.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $173.78 | Professional | None | $83.18 | $97.72 | $173.78 |
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 $56.23 Median $72.44 Typical High $190.55 | Professional | None | $56.23 | $72.44 | $190.55 |
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 $37.15 Median $39.81 Typical High $47.86 | Professional | 52 · Reduced service | $37.15 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.85 Typical High $19.50 | Professional | 53 · Discontinued | $14.79 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $58.88 Typical High $72.44 | Professional | 54 · Surgery only | $56.23 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.75 Typical High $14.45 | Professional | 55 · Aftercare only | $11.22 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.94 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.41 | $7.94 | $9.77 |
Where Washington, DC sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 40th of 51
$75.86
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.