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 $173.78 Median $2,691.53 Typical High $3,981.07 | Professional | None | $173.78 | $2,691.53 | $3,981.07 |
CareFirst Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $173.78 | Professional | None | $158.49 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,265.80 Typical High $6,918.31 | Facility | None | $512.86 | $4,265.80 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $575.44 Typical High $5,754.40 | Professional | None | $169.82 | $575.44 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $6,025.60 | Professional | None | $3,981.07 | $4,677.35 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $158.49 Median $2,754.23 Typical High $6,760.83 | Professional | None | $158.49 | $2,754.23 | $6,760.83 |
Wellpoint Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $6,309.57 | Professional | None | $2,818.38 | $2,818.38 | $6,309.57 |
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 $85.11 Median $1,348.96 Typical High $1,819.70 | Professional | 52 · Reduced service | $85.11 | $1,348.96 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $537.03 Typical High $724.44 | Professional | 53 · Discontinued | $34.67 | $537.03 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $1,995.26 Typical High $2,754.23 | Professional | 54 · Surgery only | $128.82 | $1,995.26 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $398.11 Typical High $549.54 | Professional | 55 · Aftercare only | $25.70 | $398.11 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $269.15 Typical High $363.08 | Professional | 56 · Pre-op care only | $17.38 | $269.15 | $363.08 |
Where Maryland sits
The same service costs 15.8 times more in Washington 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· 39th of 51
$2,754
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.