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 $933.25 Median $977.24 Typical High $1,819.70 | Professional | None | $933.25 | $977.24 | $1,819.70 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $870.96 | Professional | None | $776.25 | $851.14 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $12,882.50 Typical High $21,877.62 | Facility | None | $512.86 | $12,882.50 | $21,877.62 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,995.26 | Professional | None | $758.58 | $812.83 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,513.56 | Professional | None | $707.95 | $831.76 | $1,513.56 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $2,187.76 | Professional | None | $741.31 | $1,071.52 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,096.48 | Professional | None | $660.69 | $660.69 | $1,096.48 |
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 $467.74 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $467.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $707.95 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $97.72 |
Where Maryland sits
The same service costs 8.5 times more in Oklahoma 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· 45th of 51
$1,096
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.