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 $537.03 Median $562.34 Typical High $562.34 | Professional | None | $537.03 | $562.34 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $537.03 | Professional | None | $446.68 | $501.19 | $537.03 |
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 $426.58 Median $524.81 Typical High $1,202.26 | Professional | None | $426.58 | $524.81 | $1,202.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $933.25 | Professional | None | $436.52 | $512.86 | $933.25 |
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 $426.58 Median $645.65 Typical High $1,258.93 | Professional | None | $426.58 | $645.65 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $676.08 | Professional | None | $457.09 | $457.09 | $676.08 |
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 $269.15 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $269.15 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $107.15 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $398.11 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $79.43 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $56.23 |
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· 50th of 51
$525
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.