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 $141.25 Median $147.91 Typical High $223.87 | Professional | None | $141.25 | $147.91 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $112.20 Median $125.89 Typical High $158.49 | Professional | None | $112.20 | $125.89 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,162.28 Typical High $5,248.07 | Facility | None | $512.86 | $3,162.28 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $309.03 | Professional | None | $112.20 | $120.23 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $245.47 | Professional | None | $109.65 | $128.82 | $245.47 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $331.13 | Professional | None | $117.49 | $181.97 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $169.82 | Professional | None | $112.20 | $112.20 | $169.82 |
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 $70.79 Median $72.44 Typical High $74.13 | Professional | 52 · Reduced service | $70.79 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 53 · Discontinued | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $107.15 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $21.88 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $21.88 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.45 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.13 | $14.45 | $14.79 |
Where Maryland sits
The same service costs 18.2 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· 27th of 51
$245
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.