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 $354.81 Median $354.81 Typical High $363.08 | Professional | None | $354.81 | $354.81 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $426.58 | Professional | None | $323.59 | $354.81 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,348.96 | $1,778.28 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $1,000.00 | Professional | None | $323.59 | $389.05 | $1,000.00 |
Kaiser Permanente Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $645.65 | Professional | None | $309.03 | $354.81 | $645.65 |
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 $302.00 Median $446.68 Typical High $831.76 | Professional | None | $302.00 | $446.68 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $467.74 | Professional | None | $269.15 | $269.15 | $467.74 |
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 $177.83 Median $177.83 Typical High $181.97 | Professional | 52 · Reduced service | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | 53 · Discontinued | $70.79 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 54 · Surgery only | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $53.70 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $36.31 |
Where Maryland sits
The same service costs 10.5 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· 41st of 51
$447
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.