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 $446.68 Median $1,148.15 Typical High $8,128.31 | Professional | None | $446.68 | $1,148.15 | $8,128.31 |
CareFirst Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $426.58 | Professional | None | $354.81 | $398.11 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $6,165.95 | Facility | None | $512.86 | $3,548.13 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $1,174.90 Typical High $10,715.19 | Professional | None | $363.08 | $1,174.90 | $10,715.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,128.61 Median $6,606.93 Typical High $12,589.25 | Professional | None | $5,128.61 | $6,606.93 | $12,589.25 |
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 $363.08 Median $1,000.00 Typical High $15,488.17 | Professional | None | $363.08 | $1,000.00 | $15,488.17 |
Wellpoint Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $9,120.11 | Professional | None | $4,677.35 | $4,677.35 | $9,120.11 |
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 $223.87 Median $257.04 Typical High $3,981.07 | Professional | 52 · Reduced service | $223.87 | $257.04 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $102.33 Typical High $1,621.81 | Professional | 53 · Discontinued | $89.13 | $102.33 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $389.05 Typical High $6,025.60 | Professional | 54 · Surgery only | $331.13 | $389.05 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $77.62 Typical High $1,202.26 | Professional | 55 · Aftercare only | $67.61 | $77.62 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $51.29 Typical High $812.83 | Professional | 56 · Pre-op care only | $44.67 | $51.29 | $812.83 |
Where Maryland sits
The same service costs 13.2 times more in Oregon 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· 42nd of 51
$3,715
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.