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 $131.83 Median $141.25 Typical High $144.54 | Professional | None | $131.83 | $141.25 | $144.54 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $144.54 | Professional | None | $112.20 | $125.89 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,995.26 Typical High $3,388.44 | Facility | None | $331.13 | $1,995.26 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $288.40 | Professional | None | $109.65 | $120.23 | $288.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $218.78 | Professional | None | $104.71 | $120.23 | $218.78 |
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 $102.33 Median $151.36 Typical High $323.59 | Professional | None | $102.33 | $151.36 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $158.49 | Professional | None | $91.20 | $91.20 | $158.49 |
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 $66.07 Median $70.79 Typical High $72.44 | Professional | 52 · Reduced service | $66.07 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $28.84 | Professional | 53 · Discontinued | $26.30 | $28.18 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $104.71 Typical High $109.65 | Professional | 54 · Surgery only | $97.72 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $20.89 Typical High $21.88 | Professional | 55 · Aftercare only | $19.95 | $20.89 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $14.45 |
Where Maryland sits
The same service costs 12.9 times more in Arkansas 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· 32nd of 51
$214
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.