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 Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $660.69 | Facility | None | $467.74 | $467.74 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $467.74 | Professional | None | $234.42 | $338.84 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $323.59 | Professional | None | $281.84 | $309.03 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,238.72 Typical High $3,801.89 | Facility | None | $446.68 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $758.58 | Professional | None | $263.03 | $389.05 | $758.58 |
Kaiser Permanente Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $691.83 | Professional | None | $346.74 | $489.78 | $691.83 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $263.03 Median $446.68 Typical High $776.25 | Professional | None | $263.03 | $446.68 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $645.65 | Professional | None | $346.74 | $346.74 | $645.65 |
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 $117.49 Median $165.96 Typical High $169.82 | Professional | 52 · Reduced service | $117.49 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $173.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $34.67 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.44 | $33.88 | $33.88 |
Where Maryland sits
The same service costs 3.9 times more in Alaska 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· 50th of 51
$363
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.