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 $331.13 Median $851.14 Typical High $5,754.40 | Professional | None | $331.13 | $851.14 | $5,754.40 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | None | $323.59 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $5,128.61 Typical High $8,709.64 | Facility | None | $512.86 | $5,128.61 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $1,000.00 Typical High $8,128.31 | Professional | None | $316.23 | $1,000.00 | $8,128.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,248.07 Median $6,025.60 Typical High $10,964.78 | Professional | None | $5,248.07 | $6,025.60 | $10,964.78 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $316.23 Median $3,801.89 Typical High $10,715.19 | Professional | None | $316.23 | $3,801.89 | $10,715.19 |
Wellpoint Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $8,317.64 | Professional | None | $5,011.87 | $5,011.87 | $8,317.64 |
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 $165.96 Median $257.04 Typical High $2,818.38 | Professional | 52 · Reduced service | $165.96 | $257.04 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $104.71 Typical High $1,148.15 | Professional | 53 · Discontinued | $66.07 | $104.71 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $4,265.80 | Professional | 54 · Surgery only | $245.47 | $389.05 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $77.62 Typical High $851.14 | Professional | 55 · Aftercare only | $48.98 | $77.62 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $575.44 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $575.44 |
Where Maryland sits
The same service costs 18.2 times more in Alaska than in Kentucky. 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· 42nd of 51
$776
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.