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 $154.88 Median $169.82 Typical High $229.09 | Professional | None | $154.88 | $169.82 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $199.53 | Professional | None | $147.91 | $165.96 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $1,621.81 | Facility | None | $446.68 | $870.96 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $398.11 | Professional | None | $151.36 | $194.98 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $281.84 | Professional | None | $144.54 | $165.96 | $281.84 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $3,090.30 | Facility | None | $758.58 | $1,412.54 | $3,090.30 |
United Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $398.11 | Professional | None | $141.25 | $213.80 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $218.78 | Professional | None | $128.82 | $128.82 | $218.78 |
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 $85.11 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $34.67 Typical High $38.02 | Professional | 53 · Discontinued | $33.88 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $18.62 |
Where Maryland sits
The same service costs 5.8 times more in Kansas 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· 37th of 51
$219
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.