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 $263.03 Median $288.40 Typical High $575.44 | Professional | None | $263.03 | $288.40 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $263.03 | Professional | None | $229.09 | $257.04 | $263.03 |
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 $218.78 Median $269.15 Typical High $602.56 | Professional | None | $218.78 | $269.15 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $467.74 | Professional | None | $223.87 | $263.03 | $467.74 |
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 $213.80 Median $316.23 Typical High $645.65 | Professional | None | $213.80 | $316.23 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $338.84 | Professional | None | $208.93 | $208.93 | $338.84 |
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 $134.90 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $53.70 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $218.78 | Professional | 54 · Surgery only | $204.17 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.92 | $28.84 | $28.84 |
Where Maryland sits
The same service costs 4.1 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· 47th of 51
$295
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.