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 $223.87 Median $2,454.71 Typical High $5,248.07 | Facility | None | $223.87 | $2,454.71 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $562.34 Typical High $2,454.71 | Professional | None | $223.87 | $562.34 | $2,454.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $112.20 Typical High $489.78 | Professional | 52 · Reduced service | $112.20 | $112.20 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $199.53 | Professional | 53 · Discontinued | $44.67 | $44.67 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $147.91 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $100.00 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $100.00 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $6,309.57 | Professional | None | $204.17 | $229.09 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $512.86 Typical High $2,137.96 | Professional | None | $199.53 | $512.86 | $2,137.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,862.09 | Professional | None | $954.99 | $1,000.00 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $7,943.28 Typical High $27,542.29 | Facility | None | $1,737.80 | $7,943.28 | $27,542.29 |
United Setting Professional Modifier None Typical Low $181.97 Median $524.81 Typical High $2,187.76 | Professional | None | $181.97 | $524.81 | $2,187.76 |
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 $165.96 Median $169.82 Typical High $741.31 | Professional | 54 · Surgery only | $165.96 | $169.82 | $741.31 |
Where Washington, DC sits
The same service costs 4.4 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· 39th of 51
$550
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.