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 $645.65 Median $660.69 Typical High $691.83 | Professional | None | $645.65 | $660.69 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | None | $602.56 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $10,232.93 Typical High $16,982.44 | Facility | None | $512.86 | $10,232.93 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,548.82 | Professional | None | $588.84 | $724.44 | $1,548.82 |
Kaiser Permanente Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $891.25 | Professional | None | $588.84 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $3,801.89 Typical High $7,079.46 | Facility | None | $1,621.81 | $3,801.89 | $7,079.46 |
United Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,584.89 | Professional | None | $549.54 | $851.14 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $891.25 | Professional | None | $524.81 | $524.81 | $891.25 |
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 $323.59 Median $331.13 Typical High $346.74 | Professional | 52 · Reduced service | $323.59 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $131.83 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $100.00 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $66.07 Typical High $69.18 | Professional | 56 · Pre-op care only | $64.57 | $66.07 | $69.18 |
Where Maryland sits
The same service costs 11.7 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· 41st of 51
$724
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.