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 $251.19 Median $251.19 Typical High $257.04 | Professional | None | $251.19 | $251.19 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $302.00 | Professional | None | $218.78 | $245.47 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $1,202.26 | Facility | None | $512.86 | $676.08 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $363.08 | Professional | None | $213.80 | $229.09 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $331.13 | Professional | None | $199.53 | $218.78 | $331.13 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $426.58 | Professional | None | $190.55 | $234.42 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $275.42 | Professional | None | $186.21 | $186.21 | $275.42 |
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 $125.89 Median $125.89 Typical High $128.82 | Professional | 52 · Reduced service | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $52.48 | Professional | 53 · Discontinued | $50.12 | $50.12 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 54 · Surgery only | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.90 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.70 |
Where Maryland sits
The same service costs 4.7 times more in Wyoming than in Utah. 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· 41st 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.