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 $123.03 Median $147.91 Typical High $229.09 | Professional | None | $123.03 | $147.91 | $229.09 |
CareFirst Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | None | $120.23 | $134.90 | $134.90 |
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 $112.20 Median $138.04 Typical High $316.23 | Professional | None | $112.20 | $138.04 | $316.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $234.42 | Professional | None | $112.20 | $131.83 | $234.42 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $331.13 | Professional | None | $112.20 | $165.96 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $169.82 | Professional | None | $114.82 | $114.82 | $169.82 |
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 $70.79 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $70.79 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $28.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $107.15 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.13 | $14.79 | $15.14 |
Where Maryland sits
The same service costs 5.6 times more in Oklahoma 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· 46th of 51
$145
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.