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 $190.55 Median $199.53 Typical High $199.53 | Professional | None | $190.55 | $199.53 | $199.53 |
CareFirst Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | None | $186.21 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $977.24 Typical High $1,737.80 | Facility | None | $446.68 | $977.24 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $346.74 | Professional | None | $173.78 | $186.21 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $194.98 Median $223.87 Typical High $338.84 | Professional | None | $194.98 | $223.87 | $338.84 |
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 $147.91 Median $181.97 Typical High $407.38 | Professional | None | $147.91 | $181.97 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $295.12 | Professional | None | $181.97 | $181.97 | $295.12 |
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 $95.50 Median $95.50 Typical High $97.72 | Professional | 52 · Reduced service | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | 53 · Discontinued | $38.02 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 54 · Surgery only | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.95 |
Where Maryland sits
The same service costs 4.5 times more in Alaska 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· 48th of 51
$200
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.