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 $794.33 Median $4,897.79 Typical High $10,000.00 | Professional | None | $794.33 | $4,897.79 | $10,000.00 |
CareFirst Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | None | $645.65 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $6,918.31 Typical High $12,302.69 | Facility | None | $512.86 | $6,918.31 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,995.26 Typical High $12,022.64 | Professional | None | $602.56 | $1,995.26 | $12,022.64 |
Kaiser Permanente Setting Professional Modifier None Typical Low $5,754.40 Median $7,585.78 Typical High $14,125.38 | Professional | None | $5,754.40 | $7,585.78 | $14,125.38 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $7,413.10 Typical High $18,620.87 | Facility | None | $3,019.95 | $7,413.10 | $18,620.87 |
United Setting Professional Modifier None Typical Low $660.69 Median $5,754.40 Typical High $16,595.87 | Professional | None | $660.69 | $5,754.40 | $16,595.87 |
Wellpoint Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $10,232.93 | Professional | None | $5,754.40 | $5,754.40 | $10,232.93 |
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 $398.11 Median $2,454.71 Typical High $4,466.84 | Professional | 52 · Reduced service | $398.11 | $2,454.71 | $4,466.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $977.24 Typical High $1,819.70 | Professional | 53 · Discontinued | $158.49 | $977.24 | $1,819.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $3,630.78 Typical High $6,760.83 | Professional | 54 · Surgery only | $588.84 | $3,630.78 | $6,760.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $724.44 Typical High $1,348.96 | Professional | 55 · Aftercare only | $117.49 | $724.44 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $489.78 Typical High $912.01 | Professional | 56 · Pre-op care only | $79.43 | $489.78 | $912.01 |
Where Maryland sits
The same service costs 8.7 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
$5,754
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.