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 $75.86 Median $1,548.82 Typical High $3,311.31 | Facility | None | $75.86 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $363.08 | Professional | None | $75.86 | $144.54 | $363.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $72.44 | Professional | 52 · Reduced service | $38.02 | $38.02 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $28.84 | Professional | 53 · Discontinued | $15.14 | $15.14 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.48 Typical High $21.88 | Professional | 55 · Aftercare only | $11.22 | $11.48 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $14.45 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $707.95 | Professional | None | $72.44 | $79.43 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $323.59 | Professional | None | $66.07 | $125.89 | $323.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $275.42 | Professional | None | $141.25 | $147.91 | $275.42 |
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 $61.66 Median $151.36 Typical High $323.59 | Professional | None | $61.66 | $151.36 | $323.59 |
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 $56.23 Median $57.54 Typical High $109.65 | Professional | 54 · Surgery only | $56.23 | $57.54 | $109.65 |
Where Washington, DC sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 20th of 51
$145
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.