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 $61.66 Median $2,818.38 Typical High $4,786.30 | Facility | None | $61.66 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $169.82 Typical High $229.09 | Professional | None | $61.66 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $85.11 Typical High $114.82 | Professional | 52 · Reduced service | $30.90 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $12.30 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $9.12 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $16.98 Typical High $22.91 | Professional | 56 · Pre-op care only | $6.17 | $16.98 | $22.91 |
CareFirst Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $549.54 | Professional | None | $63.10 | $70.79 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $144.54 Typical High $562.34 | Professional | None | $53.70 | $144.54 | $562.34 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $281.84 Typical High $512.86 | Professional | None | $141.25 | $281.84 | $512.86 |
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 $61.66 Median $147.91 Typical High $549.54 | Professional | None | $61.66 | $147.91 | $549.54 |
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 $45.71 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $45.71 | $128.82 | $173.78 |
Where Washington, DC sits
The same service costs 4.7 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
$135
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.