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 $870.96 Median $3,090.30 Typical High $6,606.93 | Facility | None | $870.96 | $3,090.30 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $1,584.89 Typical High $4,073.80 | Professional | None | $416.87 | $1,584.89 | $4,073.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $812.83 Typical High $1,380.38 | Professional | 52 · Reduced service | $229.09 | $812.83 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $323.59 Typical High $549.54 | Professional | 53 · Discontinued | $91.20 | $323.59 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $245.47 Typical High $416.87 | Professional | 55 · Aftercare only | $67.61 | $245.47 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $162.18 Typical High $275.42 | Professional | 56 · Pre-op care only | $45.71 | $162.18 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,000.00 Typical High $4,073.80 | Professional | None | $346.74 | $1,000.00 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $2,630.27 Typical High $5,011.87 | Professional | None | $851.14 | $2,630.27 | $5,011.87 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $12,589.25 Typical High $42,657.95 | Facility | None | $4,073.80 | $12,589.25 | $42,657.95 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,380.38 Typical High $6,025.60 | Professional | None | $338.84 | $1,380.38 | $6,025.60 |
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 $338.84 Median $1,202.26 Typical High $2,089.30 | Professional | 54 · Surgery only | $338.84 | $1,202.26 | $2,089.30 |
Where Washington, DC sits
The same service costs 6.3 times more in Washington 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
$1,023
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.