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 $141.25 Median $154.88 Typical High $169.82 | Professional | None | $141.25 | $154.88 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $190.55 | Professional | None | $141.25 | $154.88 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,698.24 Typical High $2,754.23 | Facility | None | $446.68 | $1,698.24 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $363.08 | Professional | None | $138.04 | $173.78 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $245.47 | Professional | None | $131.83 | $151.36 | $245.47 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $354.81 | Professional | None | $125.89 | $190.55 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $199.53 | Professional | None | $114.82 | $114.82 | $199.53 |
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 $77.62 Median $77.62 Typical High $85.11 | Professional | 52 · Reduced service | $77.62 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | 53 · Discontinued | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $117.49 Typical High $128.82 | Professional | 54 · Surgery only | $114.82 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.44 Typical High $25.70 | Professional | 55 · Aftercare only | $22.91 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $16.98 |
Where Maryland sits
The same service costs 11.2 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· 35th of 51
$200
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.