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 $60.26 Median $162.18 Typical High $3,311.31 | Facility | None | $60.26 | $162.18 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $151.36 | Professional | None | $48.98 | $60.26 | $151.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $25.12 Typical High $30.20 | Professional | 52 · Reduced service | $24.55 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.00 Typical High $12.02 | Professional | 53 · Discontinued | $9.77 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.59 Typical High $9.12 | Professional | 55 · Aftercare only | $7.41 | $7.59 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.01 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.90 | $5.01 | $6.03 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $707.95 | Professional | None | $46.77 | $51.29 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $158.49 | Professional | None | $50.12 | $70.79 | $158.49 |
Kaiser Permanente Setting Professional Modifier None Typical Low $63.10 Median $66.07 Typical High $134.90 | Professional | None | $63.10 | $66.07 | $134.90 |
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 $45.71 Median $85.11 Typical High $154.88 | Professional | None | $45.71 | $85.11 | $154.88 |
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 $36.31 Median $38.02 Typical High $44.67 | Professional | 54 · Surgery only | $36.31 | $38.02 | $44.67 |
Where Washington, DC sits
The same service costs 4.8 times more in Alaska 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· 45th of 51
$61.66
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.