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 $323.59 Median $354.81 Typical High $416.87 | Professional | None | $323.59 | $354.81 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $354.81 | Professional | None | $288.40 | $323.59 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $2,818.38 | Facility | None | $331.13 | $1,698.24 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $933.25 | Professional | None | $309.03 | $407.38 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $660.69 | Professional | None | $416.87 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $812.83 | Professional | None | $295.12 | $467.74 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $630.96 | Professional | None | $302.00 | $302.00 | $630.96 |
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 $158.49 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $158.49 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $64.57 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $239.88 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $47.86 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $41.69 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $41.69 |
Where Maryland sits
The same service costs 3.8 times more in Alaska than in New York. 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
$407
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.