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 $263.03 Typical High $524.81 | Professional | None | $251.19 | $263.03 | $524.81 |
CareFirst Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $309.03 | Professional | None | $234.42 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,737.80 Typical High $2,818.38 | Facility | None | $446.68 | $1,737.80 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $724.44 | Professional | None | $245.47 | $288.40 | $724.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $467.74 | Professional | None | $229.09 | $263.03 | $467.74 |
United Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $2,570.40 | Facility | None | $776.25 | $1,412.54 | $2,570.40 |
United Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $602.56 | Professional | None | $218.78 | $323.59 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $338.84 | Professional | None | $194.98 | $194.98 | $338.84 |
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 $128.82 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $128.82 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $52.48 | Professional | 53 · Discontinued | $51.29 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $199.53 | Professional | 54 · Surgery only | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $26.30 |
Where Maryland sits
The same service costs 5.9 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· 37th of 51
$339
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.