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 $56.23 Median $74.13 Typical High $107.15 | Facility | None | $56.23 | $74.13 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $158.49 | Professional | None | $56.23 | $72.44 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $138.04 | Professional | None | $67.61 | $70.79 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $190.55 | Professional | None | $56.23 | $67.61 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $177.83 | Professional | None | $75.86 | $141.25 | $177.83 |
United Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $190.55 | Professional | None | $53.70 | $89.13 | $190.55 |
3 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 $36.31 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $36.31 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.24 | $7.41 | $7.41 |
Where Washington, DC sits
The same service costs 2.4 times more in Alaska than in Alabama. 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· 44th of 51
$70.79
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.