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 $467.74 Median $2,454.71 Typical High $4,265.80 | Facility | None | $467.74 | $2,454.71 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $537.03 Typical High $2,454.71 | Professional | None | $213.80 | $537.03 | $2,454.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $134.90 Typical High $524.81 | Professional | 52 · Reduced service | $107.15 | $134.90 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $53.70 Typical High $208.93 | Professional | 53 · Discontinued | $42.66 | $53.70 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $39.81 Typical High $158.49 | Professional | 55 · Aftercare only | $32.36 | $39.81 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.92 Typical High $104.71 | Professional | 56 · Pre-op care only | $21.38 | $26.92 | $104.71 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $707.95 | Professional | None | $190.55 | $213.80 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $707.95 Typical High $2,754.23 | Professional | None | $204.17 | $707.95 | $2,754.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $2,137.96 | Professional | None | $954.99 | $1,000.00 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $27,542.29 | Facility | None | $1,288.25 | $5,754.40 | $27,542.29 |
United Setting Professional Modifier None Typical Low $190.55 Median $575.44 Typical High $2,398.83 | Professional | None | $190.55 | $575.44 | $2,398.83 |
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 $158.49 Median $199.53 Typical High $794.33 | Professional | 54 · Surgery only | $158.49 | $199.53 | $794.33 |
Where Washington, DC sits
The same service costs 3.9 times more in Wisconsin than in Nebraska. 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
$631
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.