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 $41.69 Median $1,548.82 Typical High $3,311.31 | Facility | None | $41.69 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $104.71 Typical High $812.83 | Professional | None | $41.69 | $104.71 | $812.83 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $24.55 Typical High $165.96 | Professional | 52 · Reduced service | $20.89 | $24.55 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.77 Typical High $66.07 | Professional | 53 · Discontinued | $8.32 | $9.77 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.41 Typical High $48.98 | Professional | 55 · Aftercare only | $6.31 | $7.41 | $48.98 |
CareFirst Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $707.95 | Professional | None | $47.86 | $52.48 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $245.47 Typical High $912.01 | Professional | None | $42.66 | $245.47 | $912.01 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $331.13 Typical High $891.25 | Professional | None | $95.50 | $331.13 | $891.25 |
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 $40.74 Median $120.23 Typical High $851.14 | Professional | None | $40.74 | $120.23 | $851.14 |
2 more rates 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 $30.90 Median $37.15 Typical High $245.47 | Professional | 54 · Surgery only | $30.90 | $37.15 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $30.90 Typical High $33.11 | Professional | 56 · Pre-op care only | $4.17 | $30.90 | $33.11 |
Where Washington, DC sits
The same service costs 6.9 times more in Iowa 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· 45th of 51
$129
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.