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 $128.82 Median $239.88 Typical High $338.84 | Professional | None | $128.82 | $239.88 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $154.88 | Professional | None | $114.82 | $128.82 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $218.78 Typical High $1,096.48 | Facility | None | $138.04 | $218.78 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $467.74 | Professional | None | $125.89 | $229.09 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $426.58 | Professional | None | $239.88 | $281.84 | $426.58 |
United Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $1,380.38 | Facility | None | $407.38 | $645.65 | $1,380.38 |
United Setting Professional Modifier None Typical Low $131.83 Median $269.15 Typical High $645.65 | Professional | None | $131.83 | $269.15 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $371.54 | Professional | None | $213.80 | $213.80 | $371.54 |
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 $64.57 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $64.57 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $25.70 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $95.50 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $31.62 Typical High $38.02 | Professional | 55 · Aftercare only | $19.05 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $25.70 |
Where Maryland sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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
$240
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.