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 $234.42 Median $2,818.38 Typical High $4,786.30 | Facility | None | $234.42 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $676.08 Typical High $1,047.13 | Professional | None | $229.09 | $676.08 | $1,047.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $338.84 Typical High $524.81 | Professional | 52 · Reduced service | $114.82 | $338.84 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $134.90 Typical High $208.93 | Professional | 53 · Discontinued | $45.71 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $100.00 Typical High $154.88 | Professional | 55 · Aftercare only | $34.67 | $100.00 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $67.61 Typical High $104.71 | Professional | 56 · Pre-op care only | $22.91 | $67.61 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $630.96 | Professional | None | $199.53 | $218.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $562.34 Typical High $1,737.80 | Professional | None | $213.80 | $562.34 | $1,737.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $1,995.26 | Professional | None | $467.74 | $891.25 | $1,995.26 |
United Setting Facility Modifier None Typical Low $3,311.31 Median $9,772.37 Typical High $27,542.29 | Facility | None | $3,311.31 | $9,772.37 | $27,542.29 |
United Setting Professional Modifier None Typical Low $194.98 Median $602.56 Typical High $2,187.76 | Professional | None | $194.98 | $602.56 | $2,187.76 |
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 $173.78 Median $501.19 Typical High $776.25 | Professional | 54 · Surgery only | $173.78 | $501.19 | $776.25 |
Where Washington, DC sits
The same service costs 5.4 times more in Wisconsin 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
$550
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.