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 $51.29 Median $1,412.54 Typical High $7,943.28 | Facility | None | $51.29 | $1,412.54 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $91.20 | Professional | None | $51.29 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $32.36 Typical High $40.74 | Professional | 52 · Reduced service | $24.55 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.88 Typical High $16.60 | Professional | 53 · Discontinued | $10.00 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $9.55 Typical High $12.30 | Professional | 55 · Aftercare only | $7.41 | $9.55 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.46 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.90 | $6.46 | $8.13 |
CareFirst Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $645.65 | Professional | None | $39.81 | $43.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $223.87 | Professional | None | $47.86 | $81.28 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $190.55 | Professional | None | $89.13 | $117.49 | $190.55 |
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 $43.65 Median $89.13 Typical High $204.17 | Professional | None | $43.65 | $89.13 | $204.17 |
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 $37.15 Median $47.86 Typical High $61.66 | Professional | 54 · Surgery only | $37.15 | $47.86 | $61.66 |
Where Washington, DC sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 36th of 51
$75.86
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.