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 $229.09 Median $245.47 Typical High $346.74 | Professional | None | $229.09 | $245.47 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $245.47 | Professional | None | $204.17 | $229.09 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $3,388.44 Typical High $5,754.40 | Facility | None | $446.68 | $3,388.44 | $5,754.40 |
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 $204.17 Median $234.42 Typical High $371.54 | Professional | None | $204.17 | $234.42 | $371.54 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $537.03 | Professional | None | $194.98 | $288.40 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $309.03 | Professional | None | $173.78 | $173.78 | $309.03 |
3 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 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 $24.55 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $24.55 |
Where Maryland sits
The same service costs 9.5 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· 40th of 51
$295
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.