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 $263.03 Typical High $275.42 | Professional | None | $245.47 | $263.03 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | None | $194.98 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $630.96 Typical High $2,691.53 | Facility | None | $588.84 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $363.08 | Professional | None | $181.97 | $208.93 | $363.08 |
Kaiser Permanente Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $263.03 | Professional | None | $165.96 | $186.21 | $263.03 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $537.03 | Professional | None | $234.42 | $288.40 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $257.04 | Professional | None | $169.82 | $169.82 | $257.04 |
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 $125.89 Typical High $131.83 | Professional | 52 · Reduced service | $123.03 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $51.29 Typical High $52.48 | Professional | 53 · Discontinued | $50.12 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $194.98 | Professional | 54 · Surgery only | $186.21 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $38.90 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $26.30 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $26.30 |
Where Maryland sits
The same service costs 6.3 times more in Wisconsin 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· 50th of 51
$219
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.