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 $426.58 Median $2,818.38 Typical High $4,786.30 | Facility | None | $426.58 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $1,819.70 Typical High $2,754.23 | Professional | None | $407.38 | $1,819.70 | $2,754.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $912.01 Typical High $1,348.96 | Professional | 52 · Reduced service | $208.93 | $912.01 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $363.08 Typical High $549.54 | Professional | 53 · Discontinued | $85.11 | $363.08 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $275.42 Typical High $407.38 | Professional | 55 · Aftercare only | $63.10 | $275.42 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $181.97 Typical High $275.42 | Professional | 56 · Pre-op care only | $42.66 | $181.97 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $4,073.80 | Professional | None | $331.13 | $363.08 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $954.99 Typical High $4,265.80 | Professional | None | $323.59 | $954.99 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $776.25 Median $2,089.30 Typical High $4,786.30 | Professional | None | $776.25 | $2,089.30 | $4,786.30 |
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 $346.74 Median $1,621.81 Typical High $5,888.44 | Professional | None | $346.74 | $1,621.81 | $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 $316.23 Median $1,380.38 Typical High $2,041.74 | Professional | 54 · Surgery only | $316.23 | $1,380.38 | $2,041.74 |
Where Washington, DC sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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· 46th of 51
$977
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.