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 $117.49 Median $117.49 Typical High $186.21 | Facility | None | $117.49 | $117.49 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $251.19 | Professional | None | $93.33 | $100.00 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $120.23 | Professional | None | $100.00 | $112.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,698.24 Typical High $2,818.38 | Facility | None | $331.13 | $1,698.24 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $263.03 | Professional | None | $100.00 | $123.03 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $194.98 | Professional | None | $100.00 | $112.20 | $194.98 |
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 $93.33 Median $138.04 Typical High $263.03 | Professional | None | $93.33 | $138.04 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $147.91 | Professional | None | $100.00 | $100.00 | $147.91 |
4 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 $46.77 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $46.77 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $20.42 | Professional | 53 · Discontinued | $18.62 | $19.95 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.13 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $10.00 |
Where Maryland sits
The same service costs 7.9 times more in Kansas 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· 33rd of 51
$141
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.