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 $602.56 Median $616.60 Typical High $912.01 | Professional | None | $602.56 | $616.60 | $912.01 |
CareFirst Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $776.25 | Professional | None | $630.96 | $707.95 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $8,511.38 Typical High $13,489.63 | Facility | None | $7,244.36 | $8,511.38 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $2,041.74 | Professional | None | $616.60 | $741.31 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,348.96 | Professional | None | $645.65 | $758.58 | $1,348.96 |
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 $588.84 Median $831.76 Typical High $1,513.56 | Professional | None | $588.84 | $831.76 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $1,000.00 | Professional | None | $575.44 | $575.44 | $1,000.00 |
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 $302.00 Median $309.03 Typical High $331.13 | Professional | 52 · Reduced service | $302.00 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $131.83 | Professional | 53 · Discontinued | $120.23 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $489.78 | Professional | 54 · Surgery only | $457.09 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $66.07 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $66.07 |
Where Maryland sits
The same service costs 6.6 times more in Louisiana than in Kentucky. 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
$977
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.