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 $398.11 Median $2,818.38 Typical High $5,248.07 | Facility | None | $398.11 | $2,818.38 | $5,248.07 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,230.27 Typical High $2,089.30 | Professional | None | $398.11 | $1,230.27 | $2,089.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $616.60 Typical High $1,047.13 | Professional | 52 · Reduced service | $199.53 | $616.60 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $245.47 Typical High $416.87 | Professional | 53 · Discontinued | $79.43 | $245.47 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $186.21 Typical High $316.23 | Professional | 55 · Aftercare only | $60.26 | $186.21 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $123.03 Typical High $208.93 | Professional | 56 · Pre-op care only | $39.81 | $123.03 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | None | $316.23 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $891.25 Typical High $3,162.28 | Professional | None | $309.03 | $891.25 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $1,995.26 Typical High $3,890.45 | Professional | None | $741.31 | $1,995.26 | $3,890.45 |
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 $295.12 Median $1,202.26 Typical High $4,677.35 | Professional | None | $295.12 | $1,202.26 | $4,677.35 |
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 $302.00 Median $912.01 Typical High $1,584.89 | Professional | 54 · Surgery only | $302.00 | $912.01 | $1,584.89 |
Where Washington, DC sits
The same service costs 5.6 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
$891
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.