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 $346.74 Median $380.19 Typical High $741.31 | Professional | None | $346.74 | $380.19 | $741.31 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $426.58 | Professional | None | $295.12 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,511.89 Typical High $3,981.07 | Facility | None | $707.95 | $2,511.89 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $812.83 | Professional | None | $309.03 | $416.87 | $812.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $588.84 | Professional | None | $288.40 | $331.13 | $588.84 |
United Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $3,890.45 | Facility | None | $954.99 | $2,089.30 | $3,890.45 |
United Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $794.33 | Professional | None | $302.00 | $467.74 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $426.58 | Professional | None | $288.40 | $288.40 | $426.58 |
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 $173.78 Median $181.97 Typical High $190.55 | Professional | 52 · Reduced service | $173.78 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $75.86 | Professional | 53 · Discontinued | $69.18 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $275.42 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $54.95 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $38.02 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $38.02 |
Where Maryland sits
The same service costs 6.5 times more in Oklahoma 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· 42nd of 51
$457
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.