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 $371.54 Median $407.38 Typical High $407.38 | Professional | None | $371.54 | $407.38 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | None | $302.00 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $851.14 | Professional | None | $309.03 | $380.19 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $616.60 | Professional | None | $295.12 | $338.84 | $616.60 |
United Setting Facility Modifier None Typical Low $12,589.25 Median $20,417.38 Typical High $30,902.95 | Facility | None | $12,589.25 | $20,417.38 | $30,902.95 |
United Setting Professional Modifier None Typical Low $295.12 Median $426.58 Typical High $912.01 | Professional | None | $295.12 | $426.58 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $446.68 | Professional | None | $295.12 | $295.12 | $446.68 |
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 $186.21 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $74.13 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $309.03 | Professional | 54 · Surgery only | $275.42 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Where Maryland sits
The same service costs 30.9 times more in Louisiana 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· 46th of 51
$427
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.