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 $257.04 Median $1,862.09 Typical High $4,073.80 | Facility | None | $257.04 | $1,862.09 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $263.03 | Professional | None | $251.19 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $125.89 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $50.12 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $39.81 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.70 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.12 | $25.70 | $26.30 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $281.84 | Professional | None | $218.78 | $245.47 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $234.42 Typical High $478.63 | Professional | None | $218.78 | $234.42 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $512.86 | Professional | None | $186.21 | $208.93 | $512.86 |
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 $181.97 Median $213.80 Typical High $562.34 | Professional | None | $181.97 | $213.80 | $562.34 |
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 $190.55 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $190.55 | $194.98 | $194.98 |
Where Washington, DC sits
The same service costs 4.7 times more in Wyoming than in Utah. 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· 41st of 51
$245
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.