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 $109.65 Median $234.42 Typical High $338.84 | Professional | None | $109.65 | $234.42 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
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 $89.13 Median $229.09 Typical High $467.74 | Professional | None | $89.13 | $229.09 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $549.54 | Professional | None | $218.78 | $295.12 | $549.54 |
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 $87.10 Median $257.04 Typical High $660.69 | Professional | None | $87.10 | $257.04 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
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 $54.95 Median $114.82 Typical High $169.82 | Professional | 52 · Reduced service | $54.95 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $21.88 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $173.78 Typical High $257.04 | Professional | 54 · Surgery only | $81.28 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $34.67 Typical High $51.29 | Professional | 55 · Aftercare only | $16.22 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $10.96 | $23.44 | $33.88 |
Where Maryland sits
The same service costs 3.6 times more in Wisconsin than in Nebraska. 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
$209
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.