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 $257.04 Median $309.03 Typical High $588.84 | Professional | None | $257.04 | $309.03 | $588.84 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $338.84 | Professional | None | $251.19 | $281.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $3,090.30 | Facility | None | $630.96 | $1,737.80 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $660.69 | Professional | None | $251.19 | $316.23 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $478.63 | Professional | None | $234.42 | $269.15 | $478.63 |
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 $234.42 Median $346.74 Typical High $645.65 | Professional | None | $234.42 | $346.74 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $354.81 | Professional | None | $208.93 | $208.93 | $354.81 |
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 $141.25 Median $141.25 Typical High $154.88 | Professional | 52 · Reduced service | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $61.66 | Professional | 53 · Discontinued | $56.23 | $56.23 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $213.80 Typical High $234.42 | Professional | 54 · Surgery only | $208.93 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $30.90 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $30.90 |
Where Maryland sits
The same service costs 7.2 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· 42nd of 51
$355
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.