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 $66.07 Median $1,548.82 Typical High $3,311.31 | Facility | None | $66.07 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $208.93 | Professional | None | $64.57 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $67.61 Typical High $104.71 | Professional | 52 · Reduced service | $32.36 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $26.92 Typical High $41.69 | Professional | 53 · Discontinued | $12.88 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $19.95 Typical High $30.90 | Professional | 55 · Aftercare only | $9.77 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $13.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.46 | $13.49 | $20.89 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $537.03 | Professional | None | $63.10 | $70.79 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $181.97 Typical High $457.09 | Professional | None | $63.10 | $181.97 | $457.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $457.09 | Professional | None | $151.36 | $204.17 | $457.09 |
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 $63.10 Median $162.18 Typical High $501.19 | Professional | None | $63.10 | $162.18 | $501.19 |
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 $47.86 Median $100.00 Typical High $154.88 | Professional | 54 · Surgery only | $47.86 | $100.00 | $154.88 |
Where Washington, DC sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 29th of 51
$162
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.