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 $89.13 Median $97.72 Typical High $97.72 | Professional | None | $89.13 | $97.72 | $97.72 |
CareFirst Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $97.72 | Professional | None | $77.62 | $87.10 | $97.72 |
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 $72.44 Median $89.13 Typical High $204.17 | Professional | None | $72.44 | $89.13 | $204.17 |
Kaiser Permanente Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $162.18 | Professional | None | $74.13 | $85.11 | $162.18 |
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 $74.13 Median $104.71 Typical High $213.80 | Professional | None | $74.13 | $104.71 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $112.20 | Professional | None | $66.07 | $66.07 | $112.20 |
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 $45.71 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $18.20 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 54 · Surgery only | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.12 | $9.77 | $9.77 |
Where Maryland sits
The same service costs 8.1 times more in Colorado 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
$110
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.