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 $218.78 Median $562.34 Typical High $794.33 | Professional | None | $218.78 | $562.34 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $213.80 | Professional | None | $169.82 | $190.55 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $478.63 Typical High $870.96 | Facility | None | $331.13 | $478.63 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $467.74 Typical High $1,096.48 | Professional | None | $177.83 | $467.74 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,288.25 | Professional | None | $537.03 | $707.95 | $1,288.25 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $177.83 Median $549.54 Typical High $1,380.38 | Professional | None | $177.83 | $549.54 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $977.24 | Professional | None | $512.86 | $512.86 | $977.24 |
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 $109.65 Median $234.42 Typical High $398.11 | Professional | 52 · Reduced service | $109.65 | $234.42 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $93.33 Typical High $158.49 | Professional | 53 · Discontinued | $43.65 | $93.33 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $354.81 Typical High $588.84 | Professional | 54 · Surgery only | $162.18 | $354.81 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $70.79 Typical High $120.23 | Professional | 55 · Aftercare only | $32.36 | $70.79 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $46.77 Typical High $79.43 | Professional | 56 · Pre-op care only | $21.88 | $46.77 | $79.43 |
Where Maryland sits
The same service costs 5.0 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· 46th of 51
$550
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.