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 $223.87 Typical High $275.42 | Professional | None | $114.82 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $104.71 Typical High $138.04 | Professional | 52 · Reduced service | $57.54 | $104.71 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $42.66 Typical High $54.95 | Professional | 53 · Discontinued | $22.91 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $31.62 Typical High $41.69 | Professional | 55 · Aftercare only | $16.98 | $31.62 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.48 | $21.38 | $27.54 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $645.65 | Professional | None | $112.20 | $125.89 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $239.88 Typical High $537.03 | Professional | None | $107.15 | $239.88 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $269.15 Typical High $616.60 | Professional | None | $263.03 | $269.15 | $616.60 |
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 $660.69 | Professional | None | $112.20 | $275.42 | $660.69 |
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 $158.49 Typical High $208.93 | Professional | 54 · Surgery only | $85.11 | $158.49 | $208.93 |
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· 36th of 51
$240
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.