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 $1,698.24 Typical High $4,073.80 | Facility | None | $165.96 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $269.15 | Professional | None | $158.49 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $81.28 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $42.66 Typical High $53.70 | Professional | 53 · Discontinued | $32.36 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $21.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.22 | $21.38 | $26.92 |
CareFirst Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $645.65 | Professional | None | $128.82 | $141.25 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $724.44 | Professional | None | $151.36 | $263.03 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $616.60 | Professional | None | $309.03 | $380.19 | $616.60 |
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 $141.25 Median $281.84 Typical High $676.08 | Professional | None | $141.25 | $281.84 | $676.08 |
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 $120.23 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $120.23 | $158.49 | $199.53 |
Where Washington, DC sits
The same service costs 3.9 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· 36th of 51
$234
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.