A keloid is the one skin lesion where the price of the procedure tells you almost nothing about the price of the outcome. Keloids recur. The American Academy of Dermatology reports that 50 to 80 percent shrink after steroid injection but many regrow within five years, and that nearly 100 percent come back after surgical excision alone. So the number worth budgeting is not what one visit costs, it is what a plan costs over about two years.
This guide prices every common option (steroid injection, cryotherapy, laser, excision, and excision plus radiation) per treatment and per course, and gives earlobe keloids after a piercing their own section because that is the single most searched case. All figures were verified in September 2026.
What Does Keloid Removal Cost Without Insurance?
Cash prices below come from price lists the practices publish themselves, two of them under state price-transparency laws. Medicare figures are calculated from the June 30, 2026 release of the CMS Physician Fee Schedule relative value file (RVU26C) at the 2026 conversion factor of $33.4009. Average submitted charges come from CMS’s Medicare Physician & Other Practitioners by Geography and Service dataset, 2024 claims released May 2026. Course totals are the unit prices multiplied out.
| Service/Type | Low | Average | High |
|---|---|---|---|
| Intralesional steroid (Kenalog) injection, per session | $60 | $168 | $300 |
| Steroid injection, 2026 Medicare rate (CPT 11900 and 11901) | $56.78 | n/a | $68.81 |
| Full steroid course, 2 to 6 injections | $120 | $672 | $1,800 |
| Cryotherapy, per session | $100 | $180 | $500 |
| Destruction of benign lesions, NH self-pay after uninsured discount (CPT 17110) | $211 | $702 | $1,184 |
| Laser treatment of a keloid, per session | $300 | $443 | $1,500 |
| Surgical excision, published dermatology self-pay prices | $120 | $669 | $845 |
| Surgical excision, plastic surgery cash range | $750 | n/a | $3,500 |
| Excision of a face or ear lesion, 2026 Medicare (CPT 11440-11446) | $142 | $194 | $398 |
| Same codes, average charge billed in an office | $321 | $436 | $926 |
| Superficial radiation therapy after excision | $900 | n/a | $2,000 |
| Radiation treatment, 2026 Medicare allowed per session (CPT 77401) | $40 | n/a | $89 |
| Dermatology office visit, self-pay | $100 | $125 | $250 |
| Earlobe keloid: office visit plus excision, plus one steroid injection | $245 | $837 | $1,650 |
| Excision plus superficial radiation, all in | $2,000 | n/a | $5,500 |
Sources conflict on excision, and the gap is real rather than an error. Dermatology practices that publish self-pay prices list a keloid excision as an office procedure at $120 to $720 (Dermatology Associates of Katy) or as a coded pair of $248 for the excision and $421 for the closure (AboutSkin Dermatology in Colorado, posted under that state’s Transparency in Health Care Prices Act). Plastic surgery practices price the same operation at $1,000 to $3,500. Arviv Medical Aesthetics in Tampa manages to do both on one page, listing “excision starting at $300” in its price block and “excision starts at $750” two lines later. Where you go matters more than what you have.
What Drives the Price
Recurrence, which is the whole story
Everything expensive about keloid treatment exists to stop the keloid returning. Excision by itself is cheap and almost always fails, so practices add something: a series of steroid injections, a pressure earring, silicone sheeting, cryotherapy, or superficial radiation therapy. Each adjuvant has its own price, and radiation is the biggest single add-on at $900 to $2,000.
Size and how many injections it takes
Arviv Medical Aesthetics prices Kenalog at $150 per area and says it typically takes two to six injections to flatten a keloid. The AAD describes plans that give injections every two to three weeks, including four sessions before surgery in some cases. At published unit prices of $60 to $300, that is a course of $120 to $1,800 for injections alone.
Location on the body
Medicare pays more to excise a lesion on the face, ears, eyelids, nose, or lips than on the trunk or limbs. In 2026 the face and ear codes (CPT 11440 to 11446) pay $141.95 to $398.47 against $127.93 to $333.67 for the trunk, arms, and legs. Keloids over a joint or under tension (chest, shoulders, upper back) are harder to close and more likely to recur, which pushes practices toward the combination plans.
Who does the procedure
The gap between a dermatology self-pay list and a plastic surgery quote for the same excision runs from roughly 2x to nearly 30x. A dermatologist doing a small excision in an exam room is a different cost structure from a surgeon doing it in a procedure suite with anesthesia support. For a small earlobe keloid, that structure is usually overkill.
Whether radiation is part of the plan
Superficial radiation therapy after excision is the most effective recurrence prevention and the most expensive line item. Arviv posts SRT starting at $900. Cash guides put it at $1,000 to $2,000. For scale, Medicare’s 2024 claims data shows CPT 77401 (superficial radiation treatment delivery) with an average allowed amount of $40.30 per session in an office against an average submitted charge of $88.51, so the cash market price for keloid SRT is many times what Medicare pays per fraction.
Cash Price vs. Insurance
Keloids sit right on the line between cosmetic and medical, and which side you land on changes the price you see by an order of magnitude.
Aetna’s clinical policy bulletin 0389 is the clearest published statement of the covered path. It considers intralesional corticosteroids, intralesional 5-fluorouracil, and cryotherapy medically necessary when keloid removal criteria are met, and it lists CPT 17110 and 17111 (destruction of benign lesions) as covered when the keloid is documented as painful, ulcerated, or itchy and causing functional impairment such as restricted movement. It also lists a long set of things it treats as experimental or unproven for keloids, including silicone products, microneedling, intense pulsed light, platelet-rich plasma, and radiofrequency. A keloid removed because you dislike how it looks is not covered anywhere.
When the medical path opens, look at the spread. In CMS’s 2024 national data, CPT 17110 was billed 3.1 million times in an office setting with an average submitted charge of $243.18 against an average Medicare allowed amount of $103.64. CPT 11900, the steroid injection, averaged $133.11 submitted against $45.70 allowed. New Hampshire’s state price-transparency site puts real numbers on what an uninsured patient actually pays for CPT 17110: a statewide average estimate of $702, with what-you-pay figures after each provider’s uninsured discount ranging from $211 at Monadnock Community Hospital to $1,184 at Dartmouth Health in Manchester, based on claims from April 2024 through June 2025. A 5.6x spread inside one small state for one code is the best argument there is for calling around.
The cosmetic side is different and, oddly, more transparent. Nobody is negotiating on your behalf, so practices post a price. That posted price is usually all-in for the procedure, which is why a $669 dermatology excision can beat a $250 “covered” visit that turns into a coinsurance bill plus a pathology charge plus a facility fee.
How to Pay Less
Start with injections and price the course, not the shot. Intralesional steroid is the cheapest first line and the one insurers are most likely to cover. Ask the practice for the per-injection price and how many they expect, then multiply. At $60 to $80 per injection (Dermatology Associates of Katy) a six-injection course is under $500 plus visits, which is less than a single laser session at most practices.
Ask for a dermatology price before a plastic surgery price. For a small keloid, especially on an earlobe, a dermatologist doing an office excision is frequently a tenth of a surgical quote. Get both quotes in writing and compare what each includes.
Look for practices that publish a self-pay list. Colorado, Texas, and several other states have transparency rules or voluntary programs that put CPT-level self-pay prices online. Those lists are the fastest way to find a fair number in your market. Search the practice name plus “self-pay pricing” before you call.
Check the hospital’s file if a hospital is involved. If the excision is scheduled at a hospital outpatient department, the hospital must publish a discounted cash price for it. Our hospital price transparency guide explains how to pull that file, and charity care may apply if the procedure is billed as medically necessary and your income qualifies.
Negotiate the quote, then the bill. Cosmetic and self-pay prices are retail prices and they move, especially for prepayment or a bundled plan. Our guide to negotiating medical bills and our negotiation script tool work on quotes as well as invoices, and our fair price tool will tell you whether the number you were given is inside the normal range.
Do the cheap prevention. Pressure earrings and silicone sheeting cost tens of dollars, not thousands. The AAD notes a pressure earring needs 12 to 20 hours a day for several months to work, which is inconvenient but far cheaper than a second round of surgery.
Earlobe Keloids: The Priced Version
Earlobe keloids after a piercing are the most common keloid people pay to remove, and they are the best-case scenario financially. The lesion is small, accessible, and closes easily, and the AAD notes that corticosteroid injections can be especially helpful there, often paired with a pressure earring afterward.
Adding published prices together gives a realistic range. A dermatology office visit at $100 to $125 plus a small excision at $120 to $720 puts a simple earlobe excision at about $245 to $845. At AboutSkin Dermatology’s posted rates, an excision (CPT 11401, $248) plus an intermediate closure (CPT 12031, $421) plus one Kenalog injection ($168) is $837. Arviv’s combination of excision from $750 plus superficial radiation from $900 is about $1,650. A specialist plastic surgery practice quoting $1,000 to $3,500 for the excision, plus $1,000 to $2,000 for radiation, tops out around $5,500.
For comparison, Medicare’s 2026 rate for excising a benign lesion on the face or ears is $141.95 to $398.47 depending on size, and the average charge doctors actually submitted for those codes in an office was $320.75 to $925.57. If a quote is far above that submitted-charge band, ask what is included.
The Bottom Line
Budget the plan, not the procedure. A steroid-injection course is $120 to $1,800 and is where most people should start. An excision alone is $120 to $3,500 and, by itself, is very likely to fail. Excision plus superficial radiation is $2,000 to $5,500 and is the version most likely to hold. Whichever route you take, get the number of sessions in writing before you pay for the first one.
If your scar is raised but not spreading past the original wound, it may be a hypertrophic scar rather than a keloid, which is cheaper to treat and responds better to resurfacing; our laser scar removal cost guide prices that path. For a general sense of what walking into a dermatology office costs before anyone touches anything, see our dermatologist cost guide, and for the pricing of other small in-office removals, our mole removal cost guide covers the same procedure codes.