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 $281.84 Median $3,548.13 Typical High $4,786.30 | Facility | None | $281.84 | $3,548.13 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $288.40 | Professional | None | $275.42 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $141.25 Typical High $144.54 | Professional | 52 · Reduced service | $138.04 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $54.95 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.18 Typical High $28.84 | Professional | 56 · Pre-op care only | $27.54 | $28.18 | $28.84 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | None | $245.47 | $269.15 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $524.81 | Professional | None | $234.42 | $257.04 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $549.54 | Professional | None | $199.53 | $223.87 | $549.54 |
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 $199.53 Median $239.88 Typical High $616.60 | Professional | None | $199.53 | $239.88 | $616.60 |
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 $208.93 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $208.93 | $213.80 | $213.80 |
Where Washington, DC sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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· 39th of 51
$269
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.