How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 Professional Modifier None Typical Low $34.67 Median $40.74 Typical High $74.13 | Professional | None | $34.67 | $40.74 | $74.13 |
CareFirst Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $43.65 | Professional | None | $33.11 | $36.31 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $602.56 | Facility | None | $120.23 | $194.98 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $89.13 | Professional | None | $33.11 | $41.69 | $89.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $31.62 Median $36.31 Typical High $66.07 | Professional | None | $31.62 | $36.31 | $66.07 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $87.10 | Professional | None | $30.90 | $46.77 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $47.86 | Professional | None | $27.54 | $27.54 | $47.86 |
5 more rates 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 52 · Reduced service Typical Low $18.62 Median $19.05 Typical High $20.42 | Professional | 52 · Reduced service | $18.62 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.59 Typical High $8.13 | Professional | 53 · Discontinued | $7.41 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $28.18 Typical High $30.90 | Professional | 54 · Surgery only | $27.54 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.62 Typical High $6.17 | Professional | 55 · Aftercare only | $5.50 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.80 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.72 | $3.80 | $4.07 |
Where Maryland sits
The same service costs 5.5 times more in Tennessee than in New York. 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.
Maryland· 41st of 51
$46.77
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.