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 $346.74 Median $2,818.38 Typical High $4,786.30 | Facility | None | $346.74 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,023.29 Typical High $1,621.81 | Professional | None | $346.74 | $1,023.29 | $1,621.81 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $512.86 Typical High $812.83 | Professional | 52 · Reduced service | $173.78 | $512.86 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $204.17 Typical High $331.13 | Professional | 53 · Discontinued | $69.18 | $204.17 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $154.88 Typical High $245.47 | Professional | 55 · Aftercare only | $52.48 | $154.88 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $102.33 Typical High $162.18 | Professional | 56 · Pre-op care only | $34.67 | $102.33 | $162.18 |
CareFirst Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | None | $269.15 | $302.00 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $776.25 Typical High $2,570.40 | Professional | None | $275.42 | $776.25 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $1,380.38 Typical High $2,951.21 | Professional | None | $645.65 | $1,380.38 | $2,951.21 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $9,772.37 Typical High $27,542.29 | Facility | None | $3,311.31 | $9,772.37 | $27,542.29 |
United Setting Professional Modifier None Typical Low $263.03 Median $933.25 Typical High $3,630.78 | Professional | None | $263.03 | $933.25 | $3,630.78 |
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 $263.03 Median $758.58 Typical High $1,230.27 | Professional | 54 · Surgery only | $263.03 | $758.58 | $1,230.27 |
Where Washington, DC sits
The same service costs 5.1 times more in Wisconsin 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· 47th of 51
$741
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.