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 $407.38 Median $436.52 Typical High $812.83 | Professional | None | $407.38 | $436.52 | $812.83 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $407.38 | Professional | None | $363.08 | $398.11 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $5,128.61 Typical High $8,317.64 | Facility | None | $616.60 | $5,128.61 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $977.24 | Professional | None | $354.81 | $457.09 | $977.24 |
Kaiser Permanente Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $660.69 | Professional | None | $371.54 | $426.58 | $660.69 |
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 $338.84 Median $512.86 Typical High $954.99 | Professional | None | $338.84 | $512.86 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $562.34 | Professional | None | $331.13 | $331.13 | $562.34 |
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 $204.17 Median $204.17 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 54 · Surgery only | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $43.65 |
Where Maryland sits
The same service costs 6.0 times more in Oklahoma 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· 38th of 51
$513
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.