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 $74.13 Median $1,698.24 Typical High $4,073.80 | Facility | None | $74.13 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $128.82 Typical High $173.78 | Professional | None | $74.13 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $64.57 Typical High $87.10 | Professional | 52 · Reduced service | $37.15 | $64.57 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $25.70 Typical High $34.67 | Professional | 53 · Discontinued | $14.79 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $19.50 Typical High $25.70 | Professional | 55 · Aftercare only | $11.22 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $12.88 Typical High $17.38 | Professional | 56 · Pre-op care only | $7.41 | $12.88 | $17.38 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $537.03 | Professional | None | $85.11 | $95.50 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $165.96 Typical High $338.84 | Professional | None | $75.86 | $165.96 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $173.78 Typical High $380.19 | Professional | None | $169.82 | $173.78 | $380.19 |
United Setting Facility Modifier None Typical Low $165.96 Median $549.54 Typical High $5,888.44 | Facility | None | $165.96 | $549.54 | $5,888.44 |
United Setting Professional Modifier None Typical Low $70.79 Median $173.78 Typical High $407.38 | Professional | None | $70.79 | $173.78 | $407.38 |
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 $56.23 Median $95.50 Typical High $128.82 | Professional | 54 · Surgery only | $56.23 | $95.50 | $128.82 |
Where Washington, DC sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 36th of 51
$151
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.