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 $870.96 Median $933.25 Typical High $954.99 | Professional | None | $870.96 | $933.25 | $954.99 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | None | $794.33 | $891.25 | $891.25 |
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 $707.95 Median $870.96 Typical High $1,995.26 | Professional | None | $707.95 | $870.96 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,548.82 | Professional | None | $724.44 | $851.14 | $1,548.82 |
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 $707.95 Median $1,023.29 Typical High $2,089.30 | Professional | None | $707.95 | $1,023.29 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $1,122.02 | Professional | None | $645.65 | $645.65 | $1,122.02 |
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 $436.52 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $95.50 |
Where Maryland sits
The same service costs 3.8 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
$871
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.