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 Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | None | $75.86 | $79.43 | $85.11 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $89.13 | Professional | None | $72.44 | $79.43 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,258.93 Typical High $2,041.74 | Facility | None | $331.13 | $1,258.93 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $223.87 | Professional | None | $72.44 | $87.10 | $223.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $147.91 | Professional | None | $70.79 | $81.28 | $147.91 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $194.98 | Professional | None | $66.07 | $97.72 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $107.15 | Professional | None | $60.26 | $60.26 | $107.15 |
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 $38.02 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $38.02 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $15.49 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $58.88 Typical High $64.57 | Professional | 54 · Surgery only | $57.54 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.75 Typical High $12.88 | Professional | 55 · Aftercare only | $11.48 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.59 | $7.94 | $8.51 |
Where Maryland sits
The same service costs 11.2 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
$100
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.