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 $117.49 Median $1,698.24 Typical High $4,073.80 | Facility | None | $117.49 | $1,698.24 | $4,073.80 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $275.42 | Professional | None | $114.82 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $57.54 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $41.69 Typical High $54.95 | Professional | 53 · Discontinued | $22.91 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.90 Typical High $40.74 | Professional | 55 · Aftercare only | $16.98 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.89 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.48 | $20.89 | $27.54 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $1,380.38 | Professional | None | $112.20 | $125.89 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $234.42 Typical High $524.81 | Professional | None | $107.15 | $234.42 | $524.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $602.56 | Professional | None | $257.04 | $269.15 | $602.56 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $6,309.57 | Facility | None | $660.69 | $1,513.56 | $6,309.57 |
United Setting Professional Modifier None Typical Low $112.20 Median $275.42 Typical High $645.65 | Professional | None | $112.20 | $275.42 | $645.65 |
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 $85.11 Median $154.88 Typical High $204.17 | Professional | 54 · Surgery only | $85.11 | $154.88 | $204.17 |
Where Washington, DC sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 35th of 51
$234
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.