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 $549.54 Median $6,456.54 Typical High $10,964.78 | Professional | None | $549.54 | $6,456.54 | $10,964.78 |
CareFirst Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $512.86 | Professional | None | $436.52 | $489.78 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $11,220.18 Typical High $18,620.87 | Facility | None | $512.86 | $11,220.18 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $1,513.56 Typical High $12,882.50 | Professional | None | $436.52 | $1,513.56 | $12,882.50 |
Kaiser Permanente Setting Professional Modifier None Typical Low $6,309.57 Median $8,317.64 Typical High $15,488.17 | Professional | None | $6,309.57 | $8,317.64 | $15,488.17 |
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 $478.63 Median $6,309.57 Typical High $18,197.01 | Professional | None | $478.63 | $6,309.57 | $18,197.01 |
Wellpoint Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $11,220.18 | Professional | None | $6,456.54 | $6,456.54 | $11,220.18 |
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 $288.40 Median $3,235.94 Typical High $4,897.79 | Professional | 52 · Reduced service | $288.40 | $3,235.94 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $1,288.25 Typical High $1,949.84 | Professional | 53 · Discontinued | $114.82 | $1,288.25 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $4,786.30 Typical High $7,244.36 | Professional | 54 · Surgery only | $426.58 | $4,786.30 | $7,244.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $954.99 Typical High $1,479.11 | Professional | 55 · Aftercare only | $85.11 | $954.99 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $645.65 Typical High $977.24 | Professional | 56 · Pre-op care only | $57.54 | $645.65 | $977.24 |
Where Maryland sits
The same service costs 12.6 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· 33rd of 51
$6,457
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.