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 $338.84 Median $380.19 Typical High $380.19 | Professional | None | $338.84 | $380.19 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $346.74 | Professional | None | $302.00 | $331.13 | $346.74 |
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 $281.84 Median $346.74 Typical High $794.33 | Professional | None | $281.84 | $346.74 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $602.56 | Professional | None | $288.40 | $331.13 | $602.56 |
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 $275.42 Median $407.38 Typical High $831.76 | Professional | None | $275.42 | $407.38 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $436.52 | Professional | None | $275.42 | $275.42 | $436.52 |
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 $173.78 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $173.78 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $38.02 |
Where Maryland sits
The same service costs 4.0 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· 47th of 51
$380
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.