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 $851.14 Median $870.96 Typical High $1,288.25 | Professional | None | $851.14 | $870.96 | $1,288.25 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | None | $794.33 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $26,302.68 Typical High $44,668.36 | Facility | None | $512.86 | $26,302.68 | $44,668.36 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $2,238.72 | Professional | None | $741.31 | $1,000.00 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,148.15 | Professional | None | $758.58 | $870.96 | $1,148.15 |
United Setting Facility Modifier None Typical Low $7,585.78 Median $13,803.84 Typical High $21,877.62 | Facility | None | $7,585.78 | $13,803.84 | $21,877.62 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,238.72 | Professional | None | $794.33 | $1,202.26 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $1,071.52 Typical High $1,148.15 | Professional | None | $758.58 | $1,071.52 | $1,148.15 |
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 $426.58 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $169.82 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $630.96 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $85.11 | $87.10 | $87.10 |
Where Maryland sits
The same service costs 11.0 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· 40th of 51
$1,047
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.