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 $208.93 Median $213.80 Typical High $223.87 | Professional | None | $208.93 | $213.80 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $239.88 | Professional | None | $194.98 | $218.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $3,630.78 Typical High $6,456.54 | Facility | None | $588.84 | $3,630.78 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $512.86 | Professional | None | $186.21 | $245.47 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $346.74 | Professional | None | $186.21 | $213.80 | $346.74 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $501.19 | Professional | None | $186.21 | $288.40 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $281.84 | Professional | None | $186.21 | $186.21 | $281.84 |
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 $104.71 Median $107.15 Typical High $112.20 | Professional | 52 · Reduced service | $104.71 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $45.71 | Professional | 53 · Discontinued | $41.69 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $162.18 Typical High $169.82 | Professional | 54 · Surgery only | $154.88 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $33.88 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $22.39 |
Where Maryland sits
The same service costs 6.9 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· 38th of 51
$282
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.