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 $81.28 Median $85.11 Typical High $89.13 | Professional | None | $81.28 | $85.11 | $89.13 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $109.65 | Professional | None | $77.62 | $87.10 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $100.00 Typical High $194.98 | Professional | None | $74.13 | $100.00 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $151.36 | Professional | None | $72.44 | $85.11 | $151.36 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $190.55 | Professional | None | $72.44 | $112.20 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $109.65 | Professional | None | $67.61 | $67.61 | $109.65 |
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 $40.74 Median $42.66 Typical High $44.67 | Professional | 52 · Reduced service | $40.74 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $16.22 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $63.10 Typical High $66.07 | Professional | 54 · Surgery only | $61.66 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $12.30 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.51 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.13 | $8.51 | $8.91 |
Where Maryland sits
The same service costs 6.5 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· 47th of 51
$97.72
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.