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 $275.42 Median $275.42 Typical High $288.40 | Professional | None | $275.42 | $275.42 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $302.00 | Professional | None | $251.19 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,778.28 Typical High $2,818.38 | Facility | None | $512.86 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $794.33 | Professional | None | $257.04 | $302.00 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $446.68 | Professional | None | $239.88 | $275.42 | $446.68 |
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 $234.42 Median $354.81 Typical High $660.69 | Professional | None | $234.42 | $354.81 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $363.08 | Professional | None | $213.80 | $213.80 | $363.08 |
3 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 54 · Surgery only Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 54 · Surgery only | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | 56 · Pre-op care only | $27.54 | $27.54 | $28.84 |
Where Maryland sits
The same service costs 7.2 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· 42nd of 51
$347
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.