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 $58.88 Median $1,698.24 Typical High $4,073.80 | Facility | None | $58.88 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $83.18 | Professional | None | $56.23 | $63.10 | $83.18 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $645.65 | Professional | None | $45.71 | $50.12 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $199.53 | Professional | None | $42.66 | $79.43 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $162.18 | Professional | None | $54.95 | $63.10 | $162.18 |
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 $74.13 Typical High $158.49 | Professional | None | $56.23 | $74.13 | $158.49 |
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 $28.18 Median $29.51 Typical High $32.36 | Professional | 52 · Reduced service | $28.18 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $13.18 | Professional | 53 · Discontinued | $11.22 | $11.75 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $44.67 Typical High $48.98 | Professional | 54 · Surgery only | $42.66 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.91 Typical High $9.77 | Professional | 55 · Aftercare only | $8.51 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.89 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.62 | $5.89 | $6.61 |
Where Washington, DC sits
The same service costs 3.6 times more in Wyoming 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· 42nd of 51
$66.07
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.