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 $102.33 Median $234.42 Typical High $407.38 | Professional | None | $102.33 | $234.42 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $131.83 | Professional | None | $79.43 | $87.10 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,621.81 Typical High $2,884.03 | Facility | None | $331.13 | $1,621.81 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $199.53 Typical High $398.11 | Professional | None | $83.18 | $199.53 | $398.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $436.52 | Professional | None | $218.78 | $288.40 | $436.52 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $501.19 | Professional | None | $95.50 | $218.78 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | None | $194.98 | $194.98 | $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 $51.29 Median $93.33 Typical High $141.25 | Professional | 52 · Reduced service | $51.29 | $93.33 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $38.02 Typical High $56.23 | Professional | 53 · Discontinued | $20.42 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $141.25 Typical High $213.80 | Professional | 54 · Surgery only | $75.86 | $141.25 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $28.18 Typical High $42.66 | Professional | 55 · Aftercare only | $15.14 | $28.18 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $19.05 Typical High $28.18 | Professional | 56 · Pre-op care only | $10.23 | $19.05 | $28.18 |
Where Maryland sits
The same service costs 4.1 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· 34th of 51
$257
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.