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 $67.61 Median $1,698.24 Typical High $4,073.80 | Facility | None | $67.61 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $181.97 | Professional | None | $64.57 | $95.50 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $61.66 | Professional | None | $53.70 | $60.26 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $147.91 Typical High $223.87 | Professional | None | $54.95 | $147.91 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $398.11 | Professional | None | $158.49 | $186.21 | $398.11 |
United Setting Professional Modifier None Typical Low $67.61 Median $169.82 Typical High $346.74 | Professional | None | $67.61 | $169.82 | $346.74 |
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 $32.36 Median $33.88 Typical High $85.11 | Professional | 52 · Reduced service | $32.36 | $33.88 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.49 Typical High $34.67 | Professional | 53 · Discontinued | $13.18 | $13.49 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $50.12 Typical High $128.82 | Professional | 54 · Surgery only | $48.98 | $50.12 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.00 Typical High $25.70 | Professional | 55 · Aftercare only | $9.77 | $10.00 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $16.98 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $16.98 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 50th of 51
$93.33
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.