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 $194.98 Median $213.80 Typical High $234.42 | Professional | None | $194.98 | $213.80 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $257.04 | Professional | None | $190.55 | $213.80 | $257.04 |
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 $190.55 Median $239.88 Typical High $501.19 | Professional | None | $190.55 | $239.88 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $354.81 | Professional | None | $181.97 | $208.93 | $354.81 |
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 $177.83 Median $263.03 Typical High $489.78 | Professional | None | $177.83 | $263.03 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $275.42 | Professional | None | $158.49 | $158.49 | $275.42 |
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 $104.71 Median $107.15 Typical High $117.49 | Professional | 52 · Reduced service | $104.71 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $46.77 | Professional | 53 · Discontinued | $41.69 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $162.18 Typical High $173.78 | Professional | 54 · Surgery only | $158.49 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $32.36 Typical High $35.48 | Professional | 55 · Aftercare only | $31.62 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.38 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.89 | $21.38 | $23.44 |
Where Maryland sits
The same service costs 6.9 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· 37th of 51
$269
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.