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 $954.99 Median $977.24 Typical High $1,202.26 | Professional | None | $954.99 | $977.24 | $1,202.26 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $50,118.72 | Facility | None | $501.19 | $501.19 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $3,311.31 | Professional | None | $1,023.29 | $1,258.93 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,949.84 | Professional | None | $933.25 | $1,096.48 | $1,949.84 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $13,803.84 Typical High $19,054.61 | Facility | None | $7,585.78 | $13,803.84 | $19,054.61 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,398.83 | Professional | None | $954.99 | $1,412.54 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,412.54 | Professional | None | $954.99 | $954.99 | $1,412.54 |
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 $478.63 Median $489.78 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $112.20 |
Where Maryland sits
The same service costs 5.0 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· 48th of 51
$1,259
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.