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 $194.98 Median $1,412.54 Typical High $7,943.28 | Facility | None | $194.98 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $338.84 | Professional | None | $194.98 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $95.50 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $53.70 Typical High $67.61 | Professional | 53 · Discontinued | $38.90 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $39.81 Typical High $51.29 | Professional | 55 · Aftercare only | $28.84 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.92 Typical High $33.88 | Professional | 56 · Pre-op care only | $19.50 | $26.92 | $33.88 |
CareFirst Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $549.54 | Professional | None | $144.54 | $162.18 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $933.25 | Professional | None | $169.82 | $338.84 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $794.33 | Professional | None | $398.11 | $446.68 | $794.33 |
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 $165.96 Median $346.74 Typical High $851.14 | Professional | None | $165.96 | $346.74 | $851.14 |
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 $144.54 Median $199.53 Typical High $257.04 | Professional | 54 · Surgery only | $144.54 | $199.53 | $257.04 |
Where Washington, DC sits
The same service costs 3.8 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· 32nd of 51
$282
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.