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 $302.00 Median $346.74 Typical High $346.74 | Professional | None | $302.00 | $346.74 | $346.74 |
CareFirst Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $371.54 | Professional | None | $295.12 | $331.13 | $371.54 |
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 $263.03 Median $323.59 Typical High $724.44 | Professional | None | $263.03 | $323.59 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $562.34 | Professional | None | $263.03 | $309.03 | $562.34 |
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 $257.04 Median $363.08 Typical High $776.25 | Professional | None | $257.04 | $363.08 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $407.38 | Professional | None | $234.42 | $234.42 | $407.38 |
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 $162.18 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $64.57 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 54 · Surgery only | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $47.86 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $34.67 |
Where Maryland sits
The same service costs 3.9 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· 44th of 51
$347
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.