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 $208.93 Median $229.09 Typical High $251.19 | Professional | None | $208.93 | $229.09 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $275.42 | Professional | None | $204.17 | $229.09 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $2,754.23 | Facility | None | $512.86 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $537.03 | Professional | None | $204.17 | $257.04 | $537.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $380.19 | Professional | None | $190.55 | $218.78 | $380.19 |
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 $186.21 Median $281.84 Typical High $524.81 | Professional | None | $186.21 | $281.84 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $288.40 | Professional | None | $169.82 | $169.82 | $288.40 |
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 $112.20 Median $114.82 Typical High $125.89 | Professional | 52 · Reduced service | $112.20 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | 53 · Discontinued | $45.71 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $25.12 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $25.12 |
Where Maryland sits
The same service costs 7.1 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
$288
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.