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 $165.96 Median $1,412.54 Typical High $7,943.28 | Facility | None | $165.96 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $295.12 | Professional | None | $162.18 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $81.28 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $33.11 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $44.67 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.22 | $23.44 | $29.51 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $645.65 | Professional | None | $128.82 | $144.54 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $295.12 Typical High $812.83 | Professional | None | $131.83 | $295.12 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $691.83 | Professional | None | $346.74 | $380.19 | $691.83 |
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 $144.54 Median $309.03 Typical High $741.31 | Professional | None | $144.54 | $309.03 | $741.31 |
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 $123.03 Median $173.78 Typical High $223.87 | Professional | 54 · Surgery only | $123.03 | $173.78 | $223.87 |
Where Washington, DC sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 34th of 51
$251
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.