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 $72.44 Median $1,548.82 Typical High $3,311.31 | Facility | None | $72.44 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $173.78 Typical High $218.78 | Professional | None | $70.79 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $69.18 Typical High $107.15 | Professional | 52 · Reduced service | $35.48 | $69.18 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $27.54 Typical High $42.66 | Professional | 53 · Discontinued | $14.13 | $27.54 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $20.42 Typical High $31.62 | Professional | 55 · Aftercare only | $10.47 | $20.42 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $13.80 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.08 | $13.80 | $21.38 |
CareFirst Setting Professional Modifier None Typical Low $69.18 Median $77.62 Typical High $537.03 | Professional | None | $69.18 | $77.62 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $190.55 Typical High $467.74 | Professional | None | $69.18 | $190.55 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $467.74 | Professional | None | $165.96 | $204.17 | $467.74 |
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 $69.18 Median $177.83 Typical High $512.86 | Professional | None | $69.18 | $177.83 | $512.86 |
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 $52.48 Median $102.33 Typical High $158.49 | Professional | 54 · Surgery only | $52.48 | $102.33 | $158.49 |
Where Washington, DC sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 28th of 51
$174
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.