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 $257.04 Median $275.42 Typical High $281.84 | Professional | None | $257.04 | $275.42 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $269.15 | Professional | None | $223.87 | $251.19 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,698.24 Typical High $3,090.30 | Facility | None | $588.84 | $1,698.24 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $575.44 | Professional | None | $208.93 | $257.04 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $436.52 | Professional | None | $208.93 | $239.88 | $436.52 |
United Setting Facility Modifier None Typical Low $208.93 Median $389.05 Typical High $4,786.30 | Facility | None | $208.93 | $389.05 | $4,786.30 |
United Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $616.60 | Professional | None | $213.80 | $316.23 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $316.23 | Professional | None | $213.80 | $213.80 | $316.23 |
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 $131.83 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $131.83 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $54.95 Typical High $56.23 | Professional | 53 · Discontinued | $52.48 | $54.95 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $27.54 Typical High $28.18 | Professional | 56 · Pre-op care only | $26.30 | $27.54 | $28.18 |
Where Maryland sits
The same service costs 4.9 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· 45th of 51
$316
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.