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 $831.76 Median $891.25 Typical High $912.01 | Professional | None | $831.76 | $891.25 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | None | $758.58 | $851.14 | $851.14 |
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 $676.08 Median $831.76 Typical High $1,905.46 | Professional | None | $676.08 | $831.76 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,479.11 | Professional | None | $691.83 | $812.83 | $1,479.11 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,995.26 | Professional | None | $676.08 | $1,000.00 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,071.52 | Professional | None | $645.65 | $645.65 | $1,071.52 |
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 $416.87 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $91.20 |
Where Maryland sits
The same service costs 3.8 times more in Wisconsin 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· 48th of 51
$832
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.