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 $186.21 Median $223.87 Typical High $426.58 | Professional | None | $186.21 | $223.87 | $426.58 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $257.04 | Professional | None | $194.98 | $213.80 | $257.04 |
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 $181.97 Median $229.09 Typical High $478.63 | Professional | None | $181.97 | $229.09 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $338.84 | Professional | None | $169.82 | $194.98 | $338.84 |
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 $165.96 Median $251.19 Typical High $467.74 | Professional | None | $165.96 | $251.19 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $257.04 | Professional | None | $151.36 | $151.36 | $257.04 |
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 $100.00 Median $102.33 Typical High $112.20 | Professional | 52 · Reduced service | $100.00 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | 53 · Discontinued | $40.74 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 54 · Surgery only | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $22.39 |
Where Maryland sits
The same service costs 6.6 times more in Kansas 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
$257
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.