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 $537.03 Median $602.56 Typical High $602.56 | Professional | None | $537.03 | $602.56 | $602.56 |
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 $407.38 Median $489.78 Typical High $1,047.13 | Professional | None | $407.38 | $489.78 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $812.83 | Professional | None | $398.11 | $457.09 | $812.83 |
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 $302.00 Median $549.54 Typical High $1,513.56 | Professional | None | $302.00 | $549.54 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
3 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 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $74.13 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $74.13 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $51.29 |
Where Maryland sits
The same service costs 7.1 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· 45th of 51
$537
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.