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 $380.19 Median $3,548.13 Typical High $4,786.30 | Facility | None | $380.19 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $398.11 | Professional | None | $338.84 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $190.55 Typical High $199.53 | Professional | 52 · Reduced service | $169.82 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $69.18 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $60.26 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $39.81 |
CareFirst Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $331.13 | Professional | None | $275.42 | $302.00 | $331.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $831.76 | Professional | None | $478.63 | $501.19 | $831.76 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $1,071.52 | Professional | None | $316.23 | $537.03 | $1,071.52 |
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 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $302.00 | Professional | 54 · Surgery only | $269.15 | $288.40 | $302.00 |
Where Washington, DC sits
The same service costs 28.2 times more in Texas than in Kentucky. 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· 39th of 51
$380
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.