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 $151.36 Median $169.82 Typical High $194.98 | Professional | None | $151.36 | $169.82 | $194.98 |
CareFirst Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $151.36 | Professional | None | $138.04 | $151.36 | $151.36 |
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 $147.91 Median $177.83 Typical High $436.52 | Professional | None | $147.91 | $177.83 | $436.52 |
Kaiser Permanente Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $323.59 | Professional | None | $173.78 | $204.17 | $323.59 |
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 $131.83 Median $204.17 Typical High $380.19 | Professional | None | $131.83 | $204.17 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $269.15 | Professional | None | $123.03 | $123.03 | $269.15 |
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 $74.13 Median $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $74.13 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $31.62 Typical High $34.67 | Professional | 53 · Discontinued | $30.20 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $112.20 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.85 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.14 | $15.85 | $17.38 |
Where Maryland sits
The same service costs 6.3 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· 40th of 51
$195
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.