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 $74.13 Median $1,548.82 Typical High $3,311.31 | Facility | None | $74.13 | $1,548.82 | $3,311.31 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $281.84 | Professional | None | $74.13 | $112.20 | $281.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $37.15 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $22.39 Typical High $22.91 | Professional | 53 · Discontinued | $14.79 | $22.39 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $10.96 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.41 | $11.22 | $11.22 |
CareFirst Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $645.65 | Professional | None | $91.20 | $102.33 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $354.81 | Professional | None | $83.18 | $134.90 | $354.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $309.03 | Professional | None | $147.91 | $154.88 | $309.03 |
United Setting Facility Modifier None Typical Low $109.65 Median $549.54 Typical High $1,548.82 | Facility | None | $109.65 | $549.54 | $1,548.82 |
United Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $354.81 | Professional | None | $85.11 | $165.96 | $354.81 |
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 $54.95 Median $85.11 Typical High $85.11 | Professional | 54 · Surgery only | $54.95 | $85.11 | $85.11 |
Where Washington, DC sits
The same service costs 3.3 times more in Wisconsin 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· 48th of 51
$120
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.