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 $269.15 Typical High $281.84 | Professional | None | $257.04 | $269.15 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $281.84 | Professional | None | $229.09 | $257.04 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,398.83 Typical High $3,981.07 | Facility | None | $446.68 | $2,398.83 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $616.60 | Professional | None | $229.09 | $288.40 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $426.58 | Professional | None | $229.09 | $263.03 | $426.58 |
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 $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 $346.74 | Professional | None | $199.53 | $199.53 | $346.74 |
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 $194.98 Median $194.98 Typical High $208.93 | Professional | 54 · Surgery only | $194.98 | $194.98 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $28.18 |
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· 39th 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.