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 $177.83 Typical High $363.08 | Professional | None | $154.88 | $177.83 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $213.80 | Professional | None | $162.18 | $177.83 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $1,548.82 | Facility | None | $446.68 | $851.14 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $398.11 | Professional | None | $151.36 | $190.55 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $275.42 | Professional | None | $141.25 | $162.18 | $275.42 |
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 $138.04 Median $208.93 Typical High $389.05 | Professional | None | $138.04 | $208.93 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $213.80 | Professional | None | $125.89 | $125.89 | $213.80 |
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 $83.18 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $83.18 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 53 · Discontinued | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | 54 · Surgery only | $125.89 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $25.12 Typical High $27.54 | Professional | 55 · Aftercare only | $25.12 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.98 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.60 | $16.98 | $18.62 |
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· 39th of 51
$214
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.