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 $257.04 Median $263.03 Typical High $478.63 | Professional | None | $257.04 | $263.03 | $478.63 |
CareFirst Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $446.68 | Professional | None | $302.00 | $331.13 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,344.23 Typical High $3,801.89 | Facility | None | $512.86 | $2,344.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $416.87 Typical High $794.33 | Professional | None | $281.84 | $416.87 | $794.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $602.56 | Professional | None | $288.40 | $331.13 | $602.56 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $3,890.45 | Facility | None | $954.99 | $1,995.26 | $3,890.45 |
United Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $794.33 | Professional | None | $295.12 | $457.09 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $436.52 | Professional | None | $288.40 | $288.40 | $436.52 |
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 $128.82 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $128.82 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $51.29 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $199.53 Typical High $229.09 | Professional | 54 · Surgery only | $194.98 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $39.81 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $26.30 | $30.20 |
Where Maryland sits
The same service costs 10.0 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
$447
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.