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 $549.54 Median $549.54 Typical High $562.34 | Professional | None | $549.54 | $549.54 | $562.34 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | None | $436.52 | $478.63 | $478.63 |
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 $416.87 Median $512.86 Typical High $1,174.90 | Professional | None | $416.87 | $512.86 | $1,174.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $891.25 | Professional | None | $426.58 | $501.19 | $891.25 |
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 $501.19 Median $851.14 Typical High $1,380.38 | Professional | None | $501.19 | $851.14 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $645.65 | Professional | None | $436.52 | $436.52 | $645.65 |
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 $275.42 Median $275.42 Typical High $281.84 | Professional | 52 · Reduced service | $275.42 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $56.23 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $56.23 |
Where Maryland sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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· 51st of 51
$550
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.