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 $39.81 Median $40.74 Typical High $43.65 | Professional | None | $39.81 | $40.74 | $43.65 |
CareFirst Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $47.86 | Professional | None | $35.48 | $38.90 | $47.86 |
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 $37.15 Median $44.67 Typical High $114.82 | Professional | None | $37.15 | $44.67 | $114.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $66.07 | Professional | None | $34.67 | $39.81 | $66.07 |
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 $33.88 Median $51.29 Typical High $95.50 | Professional | None | $33.88 | $51.29 | $95.50 |
Wellpoint Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $51.29 | Professional | None | $30.90 | $30.90 | $51.29 |
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 $19.95 Median $19.95 Typical High $20.42 | Professional | 52 · Reduced service | $19.95 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $8.32 | Professional | 53 · Discontinued | $7.94 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 54 · Surgery only | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.07 |
Where Maryland sits
The same service costs 24.5 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· 42nd of 51
$51.29
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.