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 $3,981.07 | Professional | None | $416.87 | $1,584.89 | $3,981.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $776.25 Typical High $1,348.96 | Professional | 52 · Reduced service | $223.87 | $776.25 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $316.23 Typical High $537.03 | Professional | 53 · Discontinued | $91.20 | $316.23 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $234.42 Typical High $407.38 | Professional | 55 · Aftercare only | $67.61 | $234.42 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $158.49 Typical High $269.15 | Professional | 56 · Pre-op care only | $45.71 | $158.49 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | None | $354.81 | $354.81 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $1,000.00 Typical High $3,981.07 | Professional | None | $346.74 | $1,000.00 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $2,511.89 Typical High $4,897.79 | Professional | None | $831.76 | $2,511.89 | $4,897.79 |
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 $331.13 Median $1,380.38 Typical High $5,888.44 | Professional | None | $331.13 | $1,380.38 | $5,888.44 |
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 $1,174.90 Typical High $1,995.26 | Professional | 54 · Surgery only | $338.84 | $1,174.90 | $1,995.26 |
Where Washington, DC sits
The same service costs 6.2 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
$1,000
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.