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 $208.93 Median $281.84 Typical High $398.11 | Professional | None | $208.93 | $281.84 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $234.42 | Professional | None | $194.98 | $213.80 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,023.29 Typical High $1,819.70 | Facility | None | $446.68 | $1,023.29 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $676.08 | Professional | None | $208.93 | $346.74 | $676.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $630.96 | Professional | None | $354.81 | $416.87 | $630.96 |
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 $190.55 Median $354.81 Typical High $660.69 | Professional | None | $190.55 | $354.81 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $549.54 | Professional | None | $218.78 | $218.78 | $549.54 |
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 $104.71 Median $123.03 Typical High $199.53 | Professional | 52 · Reduced service | $104.71 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $79.43 | Professional | 53 · Discontinued | $42.66 | $48.98 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $295.12 | Professional | 54 · Surgery only | $158.49 | $181.97 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $58.88 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $24.55 Typical High $39.81 | Professional | 56 · Pre-op care only | $20.89 | $24.55 | $39.81 |
Where Maryland sits
The same service costs 3.6 times more in Oklahoma than in Kentucky. 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· 27th of 51
$380
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.