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 $107.15 Median $109.65 Typical High $117.49 | Professional | None | $107.15 | $109.65 | $117.49 |
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 $501.19 Typical High $891.25 | Facility | None | $331.13 | $501.19 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $275.42 | Professional | None | $97.72 | $128.82 | $275.42 |
Kaiser Permanente Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $204.17 | Professional | None | $104.71 | $120.23 | $204.17 |
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 $100.00 Median $154.88 Typical High $269.15 | Professional | None | $100.00 | $154.88 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $158.49 | Professional | None | $104.71 | $104.71 | $158.49 |
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 $53.70 Median $54.95 Typical High $54.95 | Professional | 52 · Reduced service | $53.70 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 53 · Discontinued | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $81.28 Typical High $81.28 | Professional | 54 · Surgery only | $79.43 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $15.85 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.96 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.72 | $10.96 | $10.96 |
Where Maryland sits
The same service costs 9.8 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
$148
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.