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 $102.33 Median $104.71 Typical High $114.82 | Professional | None | $102.33 | $104.71 | $114.82 |
CareFirst Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $112.20 | Professional | None | $93.33 | $102.33 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,023.29 Typical High $1,659.59 | Facility | None | $331.13 | $1,023.29 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $295.12 | Professional | None | $95.50 | $114.82 | $295.12 |
Kaiser Permanente Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $186.21 | Professional | None | $91.20 | $104.71 | $186.21 |
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 $87.10 Median $131.83 Typical High $239.88 | Professional | None | $87.10 | $131.83 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $134.90 | Professional | None | $77.62 | $77.62 | $134.90 |
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 $51.29 Median $51.29 Typical High $52.48 | Professional | 52 · Reduced service | $51.29 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.89 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 54 · Surgery only | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.85 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.47 |
Where Maryland sits
The same service costs 16.6 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
$129
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.