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 $501.19 Median $3,801.89 Typical High $6,309.57 | Professional | None | $501.19 | $3,801.89 | $6,309.57 |
CareFirst Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $457.09 | Professional | None | $398.11 | $436.52 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,760.83 Typical High $11,220.18 | Facility | None | $512.86 | $6,760.83 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,348.96 Typical High $8,511.38 | Professional | None | $389.05 | $1,348.96 | $8,511.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $4,073.80 Median $5,370.32 Typical High $10,232.93 | Professional | None | $4,073.80 | $5,370.32 | $10,232.93 |
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 $426.58 Median $3,981.07 Typical High $10,964.78 | Professional | None | $426.58 | $3,981.07 | $10,964.78 |
Wellpoint Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $7,413.10 | Professional | None | $3,801.89 | $3,801.89 | $7,413.10 |
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 $257.04 Median $1,905.46 Typical High $3,162.28 | Professional | 52 · Reduced service | $257.04 | $1,905.46 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $758.58 Typical High $1,288.25 | Professional | 53 · Discontinued | $102.33 | $758.58 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $2,884.03 Typical High $4,786.30 | Professional | 54 · Surgery only | $389.05 | $2,884.03 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $575.44 Typical High $954.99 | Professional | 55 · Aftercare only | $77.62 | $575.44 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $380.19 Typical High $630.96 | Professional | 56 · Pre-op care only | $51.29 | $380.19 | $630.96 |
Where Maryland sits
The same service costs 10.2 times more in Wisconsin 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· 37th of 51
$4,169
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.