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 $58.88 Median $1,548.82 Typical High $3,311.31 | Facility | None | $58.88 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $229.09 Typical High $346.74 | Professional | None | $54.95 | $229.09 | $346.74 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $29.51 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $45.71 Typical High $69.18 | Professional | 53 · Discontinued | $11.75 | $45.71 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $8.71 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $5.89 | $22.91 | $34.67 |
CareFirst Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $537.03 | Professional | None | $45.71 | $51.29 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $128.82 Typical High $549.54 | Professional | None | $44.67 | $128.82 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $269.15 Typical High $616.60 | Professional | None | $107.15 | $269.15 | $616.60 |
United Setting Facility Modifier None Typical Low $165.96 Median $549.54 Typical High $5,888.44 | Facility | None | $165.96 | $549.54 | $5,888.44 |
United Setting Professional Modifier None Typical Low $44.67 Median $173.78 Typical High $741.31 | Professional | None | $44.67 | $173.78 | $741.31 |
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 $43.65 Median $173.78 Typical High $257.04 | Professional | 54 · Surgery only | $43.65 | $173.78 | $257.04 |
Where Washington, DC sits
The same service costs 4.9 times more in Iowa 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· 47th of 51
$132
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.