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 $48.98 Median $1,548.82 Typical High $3,311.31 | Facility | None | $48.98 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $120.23 Typical High $457.09 | Professional | None | $48.98 | $120.23 | $457.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $24.55 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $28.84 Typical High $36.31 | Professional | 53 · Discontinued | $9.77 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $21.38 Typical High $27.54 | Professional | 55 · Aftercare only | $7.24 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $4.90 | $14.45 | $18.20 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $707.95 | Professional | None | $56.23 | $61.66 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $151.36 Typical High $501.19 | Professional | None | $48.98 | $151.36 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $416.87 | Professional | None | $109.65 | $190.55 | $416.87 |
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 $46.77 Median $128.82 Typical High $457.09 | Professional | None | $46.77 | $128.82 | $457.09 |
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 $42.66 Typical High $138.04 | Professional | 54 · Surgery only | $36.31 | $42.66 | $138.04 |
Where Washington, DC sits
The same service costs 2.9 times more in Alaska than in Nebraska. 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· 37th of 51
$145
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.