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 $371.54 Median $371.54 Typical High $380.19 | Professional | None | $371.54 | $371.54 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $446.68 | Professional | None | $338.84 | $371.54 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $2,691.53 Typical High $4,466.84 | Facility | None | $331.13 | $2,691.53 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $1,047.13 | Professional | None | $354.81 | $407.38 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $602.56 | Professional | None | $323.59 | $371.54 | $602.56 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $870.96 | Professional | None | $316.23 | $467.74 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $489.78 | Professional | None | $281.84 | $281.84 | $489.78 |
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 $186.21 Median $186.21 Typical High $190.55 | Professional | 52 · Reduced service | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $75.86 | Professional | 53 · Discontinued | $74.13 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | 54 · Surgery only | $281.84 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $57.54 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $38.02 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $38.02 |
Where Maryland sits
The same service costs 7.8 times more in Oklahoma 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
$437
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.