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 $177.83 Median $194.98 Typical High $194.98 | Professional | None | $177.83 | $194.98 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | None | $194.98 | $213.80 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $2,454.71 Typical High $4,365.16 | Facility | None | $616.60 | $2,454.71 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $489.78 | Professional | None | $177.83 | $234.42 | $489.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $346.74 | Professional | None | $165.96 | $190.55 | $346.74 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $501.19 | Professional | None | $177.83 | $263.03 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $245.47 | Professional | None | $158.49 | $158.49 | $245.47 |
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 $89.13 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $36.31 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.92 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $17.78 | $19.50 | $19.50 |
Where Maryland sits
The same service costs 10.2 times more in Oklahoma than in Kentucky. 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
$245
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.