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 $245.47 Median $295.12 Typical High $562.34 | Professional | None | $245.47 | $295.12 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $323.59 | Professional | None | $239.88 | $269.15 | $323.59 |
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 $234.42 Median $302.00 Typical High $630.96 | Professional | None | $234.42 | $302.00 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $457.09 | Professional | None | $223.87 | $257.04 | $457.09 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $2,570.40 | Facility | None | $758.58 | $1,412.54 | $2,570.40 |
United Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $616.60 | Professional | None | $218.78 | $331.13 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $331.13 | Professional | None | $199.53 | $199.53 | $331.13 |
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 $131.83 Median $134.90 Typical High $144.54 | Professional | 52 · Reduced service | $131.83 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | 53 · Discontinued | $53.70 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $29.51 |
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· 41st of 51
$331
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.