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 $181.97 Median $1,412.54 Typical High $7,943.28 | Facility | None | $181.97 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $316.23 | Professional | None | $177.83 | $234.42 | $316.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $117.49 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $117.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $46.77 Typical High $63.10 | Professional | 53 · Discontinued | $35.48 | $46.77 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $34.67 Typical High $47.86 | Professional | 55 · Aftercare only | $26.30 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.44 Typical High $31.62 | Professional | 56 · Pre-op care only | $17.78 | $23.44 | $31.62 |
CareFirst Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $549.54 | Professional | None | $134.90 | $147.91 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $309.03 Typical High $870.96 | Professional | None | $141.25 | $309.03 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $741.31 | Professional | None | $371.54 | $416.87 | $741.31 |
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 $138.04 Median $295.12 Typical High $794.33 | Professional | None | $138.04 | $295.12 | $794.33 |
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 $131.83 Median $173.78 Typical High $239.88 | Professional | 54 · Surgery only | $131.83 | $173.78 | $239.88 |
Where Washington, DC sits
The same service costs 4.0 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· 38th 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.