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 $501.19 Median $512.86 Typical High $549.54 | Professional | None | $501.19 | $512.86 | $549.54 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $549.54 | Professional | None | $457.09 | $501.19 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $5,011.87 Typical High $8,317.64 | Facility | None | $512.86 | $5,011.87 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $1,230.27 | Professional | None | $446.68 | $575.44 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $891.25 | Professional | None | $478.63 | $537.03 | $891.25 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $1,202.26 | Professional | None | $436.52 | $645.65 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $707.95 | Professional | None | $389.05 | $389.05 | $707.95 |
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 $257.04 Median $257.04 Typical High $275.42 | Professional | 52 · Reduced service | $257.04 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 53 · Discontinued | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 54 · Surgery only | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $54.95 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $54.95 |
Where Maryland sits
The same service costs 3.9 times more in Alaska 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
$603
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.