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 $575.44 Median $588.84 Typical High $645.65 | Professional | None | $575.44 | $588.84 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $707.95 | Professional | None | $602.56 | $676.08 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $7,762.47 Median $9,120.11 Typical High $14,454.40 | Facility | None | $7,762.47 | $9,120.11 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,949.84 | Professional | None | $575.44 | $707.95 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $1,096.48 | Professional | None | $478.63 | $562.34 | $1,096.48 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $10,715.19 | Facility | None | $3,090.30 | $7,413.10 | $10,715.19 |
United Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,445.44 | Professional | None | $562.34 | $794.33 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $741.31 | Professional | None | $501.19 | $501.19 | $741.31 |
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 $288.40 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $288.40 | $295.12 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $114.82 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $436.52 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $57.54 | $58.88 | $63.10 |
Where Maryland sits
The same service costs 9.8 times more in Oklahoma 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· 41st of 51
$891
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.