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 $97.72 Median $354.81 Typical High $501.19 | Professional | None | $97.72 | $354.81 | $501.19 |
CareFirst Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | None | $75.86 | $85.11 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $489.78 Typical High $776.25 | Facility | None | $323.59 | $489.78 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $257.04 Typical High $691.83 | Professional | None | $79.43 | $257.04 | $691.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $338.84 Median $446.68 Typical High $851.14 | Professional | None | $338.84 | $446.68 | $851.14 |
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 $89.13 Median $354.81 Typical High $1,023.29 | Professional | None | $89.13 | $354.81 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $616.60 | Professional | None | $371.54 | $371.54 | $616.60 |
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 $48.98 Median $177.83 Typical High $251.19 | Professional | 52 · Reduced service | $48.98 | $177.83 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $70.79 Typical High $100.00 | Professional | 53 · Discontinued | $19.50 | $70.79 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $263.03 Typical High $380.19 | Professional | 54 · Surgery only | $72.44 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $52.48 Typical High $75.86 | Professional | 55 · Aftercare only | $14.45 | $52.48 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $35.48 Typical High $50.12 | Professional | 56 · Pre-op care only | $9.77 | $35.48 | $50.12 |
Where Maryland sits
The same service costs 7.8 times more in Oklahoma 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· 45th of 51
$363
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.