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 $194.98 Median $2,818.38 Typical High $4,786.30 | Facility | None | $194.98 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $380.19 | Professional | None | $194.98 | $234.42 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $75.86 Typical High $117.49 | Professional | 53 · Discontinued | $38.90 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $154.88 Typical High $288.40 | Professional | 54 · Surgery only | $147.91 | $154.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $30.90 Typical High $57.54 | Professional | 55 · Aftercare only | $29.51 | $30.90 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $20.89 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.50 | $20.89 | $38.02 |
CareFirst Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,584.89 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $660.69 | Professional | None | $363.08 | $407.38 | $660.69 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $407.38 Typical High $660.69 | Professional | 53 · Discontinued | $363.08 | $407.38 | $660.69 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $588.84 | Professional | None | $173.78 | $316.23 | $588.84 |
1 more rate 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 $72.44 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $72.44 | $97.72 | $117.49 |
Where Washington, DC sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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· 38th of 51
$302
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.