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 $588.84 Median $5,495.41 Typical High $7,413.10 | Professional | None | $588.84 | $5,495.41 | $7,413.10 |
CareFirst Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $12,302.69 Typical High $22,387.21 | Facility | None | $512.86 | $12,302.69 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $1,479.11 Typical High $9,772.37 | Professional | None | $501.19 | $1,479.11 | $9,772.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,495.41 Median $7,244.36 Typical High $12,589.25 | Professional | None | $5,495.41 | $7,244.36 | $12,589.25 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $13,803.84 Typical High $19,054.61 | Facility | None | $7,585.78 | $13,803.84 | $19,054.61 |
United Setting Professional Modifier None Typical Low $489.78 Median $5,248.07 Typical High $15,135.61 | Professional | None | $489.78 | $5,248.07 | $15,135.61 |
Wellpoint Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $10,000.00 | Professional | None | $5,248.07 | $5,248.07 | $10,000.00 |
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 $309.03 Median $2,754.23 Typical High $3,715.35 | Professional | 52 · Reduced service | $309.03 | $2,754.23 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $1,096.48 Typical High $1,479.11 | Professional | 53 · Discontinued | $123.03 | $1,096.48 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $4,073.80 Typical High $5,495.41 | Professional | 54 · Surgery only | $457.09 | $4,073.80 | $5,495.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $831.76 Typical High $1,122.02 | Professional | 55 · Aftercare only | $91.20 | $831.76 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $549.54 Typical High $741.31 | Professional | 56 · Pre-op care only | $61.66 | $549.54 | $741.31 |
Where Maryland sits
The same service costs 17.8 times more in Alaska than in Hawaii. 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· 21st of 51
$6,310
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.