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 $223.87 Median $239.88 Typical High $363.08 | Professional | None | $223.87 | $239.88 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | None | $208.93 | $229.09 | $229.09 |
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 $181.97 Median $223.87 Typical High $501.19 | Professional | None | $181.97 | $223.87 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $380.19 | Professional | None | $181.97 | $213.80 | $380.19 |
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 $181.97 Median $257.04 Typical High $524.81 | Professional | None | $181.97 | $257.04 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $275.42 | Professional | None | $162.18 | $162.18 | $275.42 |
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 $112.20 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $181.97 | Professional | 54 · Surgery only | $169.82 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $33.88 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $23.99 |
Where Maryland sits
The same service costs 3.8 times more in Alaska 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· 47th of 51
$229
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.