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 $407.38 Median $1,513.56 Typical High $1,995.26 | Professional | None | $407.38 | $1,513.56 | $1,995.26 |
CareFirst Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | None | $380.19 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,737.80 Typical High $3,162.28 | Facility | None | $512.86 | $1,737.80 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,412.54 Typical High $3,235.94 | Professional | None | $398.11 | $1,412.54 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,090.30 Median $3,981.07 Typical High $5,011.87 | Professional | None | $3,090.30 | $3,981.07 | $5,011.87 |
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 $371.54 Median $1,479.11 Typical High $4,073.80 | Professional | None | $371.54 | $1,479.11 | $4,073.80 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $5,754.40 | Professional | None | $1,621.81 | $1,621.81 | $5,754.40 |
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 $204.17 Median $758.58 Typical High $977.24 | Professional | 52 · Reduced service | $204.17 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $302.00 Typical High $389.05 | Professional | 53 · Discontinued | $81.28 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,122.02 Typical High $1,445.44 | Professional | 54 · Surgery only | $309.03 | $1,122.02 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $223.87 Typical High $288.40 | Professional | 55 · Aftercare only | $61.66 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $151.36 Typical High $194.98 | Professional | 56 · Pre-op care only | $40.74 | $151.36 | $194.98 |
Where Maryland sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 45th of 51
$1,349
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.