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 $245.47 Median $251.19 Typical High $371.54 | Professional | None | $245.47 | $251.19 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | None | $245.47 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $616.60 | Professional | None | $229.09 | $269.15 | $616.60 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $426.58 | Professional | None | $239.88 | $269.15 | $426.58 |
United Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,230.27 | Facility | None | $257.04 | $537.03 | $1,230.27 |
United Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $616.60 | Professional | None | $213.80 | $309.03 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | None | $239.88 | $239.88 | $354.81 |
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 $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $48.98 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $181.97 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $36.31 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $25.12 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $25.12 |
Where Maryland sits
The same service costs 7.9 times more in Oklahoma than in Utah. 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· 46th of 51
$269
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.