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 $109.65 Median $1,698.24 Typical High $3,467.37 | Facility | None | $109.65 | $1,698.24 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $269.15 Typical High $3,311.31 | Professional | None | $109.65 | $269.15 | $3,311.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $691.83 | Professional | 52 · Reduced service | $54.95 | $54.95 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $275.42 | Professional | 53 · Discontinued | $21.88 | $21.88 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $208.93 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $138.04 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $138.04 |
CareFirst Setting Professional Modifier None Typical Low $102.33 Median $114.82 Typical High $630.96 | Professional | None | $102.33 | $114.82 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $281.84 Typical High $2,818.38 | Professional | None | $95.50 | $281.84 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,348.96 Typical High $2,818.38 | Professional | None | $1,288.25 | $1,348.96 | $2,818.38 |
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 $89.13 Median $263.03 Typical High $3,019.95 | Professional | None | $89.13 | $263.03 | $3,019.95 |
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 $81.28 Median $83.18 Typical High $1,047.13 | Professional | 54 · Surgery only | $81.28 | $83.18 | $1,047.13 |
Where Washington, DC sits
The same service costs 9.5 times more in Washington than in Nebraska. 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· 45th of 51
$269
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.