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 $436.52 Median $478.63 Typical High $524.81 | Professional | None | $436.52 | $478.63 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | None | $436.52 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,951.21 Typical High $5,011.87 | Facility | None | $512.86 | $2,951.21 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $1,047.13 | Professional | None | $309.03 | $467.74 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $776.25 | Professional | None | $398.11 | $457.09 | $776.25 |
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 $275.42 Median $478.63 Typical High $1,096.48 | Professional | None | $275.42 | $478.63 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $602.56 | Professional | None | $181.97 | $181.97 | $602.56 |
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 $234.42 Median $239.88 Typical High $263.03 | Professional | 52 · Reduced service | $234.42 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $97.72 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $97.72 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $398.11 | Professional | 54 · Surgery only | $354.81 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $72.44 Typical High $79.43 | Professional | 55 · Aftercare only | $70.79 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $52.48 |
Where Maryland sits
The same service costs 5.2 times more in Alaska than in Kentucky. 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· 34th of 51
$525
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.