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 $24.55 Median $1,698.24 Typical High $4,786.30 | Facility | None | $24.55 | $1,698.24 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $30.20 Typical High $32.36 | Professional | None | $24.55 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $15.14 Typical High $16.22 | Professional | 52 · Reduced service | $12.30 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.03 Typical High $6.61 | Professional | 53 · Discontinued | $4.90 | $6.03 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.47 Typical High $4.90 | Professional | 55 · Aftercare only | $3.63 | $4.47 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.02 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.45 | $3.02 | $3.24 |
CareFirst Setting Professional Modifier None Typical Low $22.39 Median $25.70 Typical High $645.65 | Professional | None | $22.39 | $25.70 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $85.11 | Professional | None | $21.88 | $37.15 | $85.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $35.48 Median $56.23 Typical High $81.28 | Professional | None | $35.48 | $56.23 | $81.28 |
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 $21.88 Median $40.74 Typical High $79.43 | Professional | None | $21.88 | $40.74 | $79.43 |
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 $18.20 Median $22.39 Typical High $24.55 | Professional | 54 · Surgery only | $18.20 | $22.39 | $24.55 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska 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· 43rd of 51
$32.36
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.