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 $194.98 Median $199.53 Typical High $208.93 | Professional | None | $194.98 | $199.53 | $208.93 |
CareFirst Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | None | $190.55 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $575.44 | Professional | None | $181.97 | $218.78 | $575.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $331.13 | Professional | None | $181.97 | $204.17 | $331.13 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $478.63 | Professional | None | $165.96 | $251.19 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $269.15 | Professional | None | $154.88 | $154.88 | $269.15 |
3 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 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 54 · Surgery only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $31.62 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $20.89 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $20.89 |
Where Maryland sits
The same service costs 4.3 times more in Alaska 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· 45th of 51
$214
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.