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 $389.05 Median $1,698.24 Typical High $3,311.31 | Facility | None | $389.05 | $1,698.24 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $524.81 Typical High $954.99 | Professional | None | $190.55 | $524.81 | $954.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $251.19 Typical High $478.63 | Professional | 52 · Reduced service | $102.33 | $251.19 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $100.00 Typical High $190.55 | Professional | 53 · Discontinued | $40.74 | $100.00 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $380.19 Typical High $707.95 | Professional | 54 · Surgery only | $151.36 | $380.19 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $75.86 Typical High $141.25 | Professional | 55 · Aftercare only | $30.20 | $75.86 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $1,380.38 | Professional | None | $158.49 | $173.78 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $446.68 Typical High $1,412.54 | Professional | None | $169.82 | $446.68 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $758.58 Typical High $1,698.24 | Professional | None | $371.54 | $758.58 | $1,698.24 |
United Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $27,542.29 | Facility | None | $537.03 | $2,511.89 | $27,542.29 |
United Setting Professional Modifier None Typical Low $147.91 Median $512.86 Typical High $2,041.74 | Professional | None | $147.91 | $512.86 | $2,041.74 |
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 56 · Pre-op care only Typical Low $20.42 Median $50.12 Typical High $95.50 | Professional | 56 · Pre-op care only | $20.42 | $50.12 | $95.50 |
Where Washington, DC sits
The same service costs 5.2 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· 45th of 51
$468
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.