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 (both parts) Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None (both parts) | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $269.15 Typical High $302.00 | Professional | 26 · Professional part | $263.03 | $269.15 | $302.00 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $275.42 Median $302.00 Typical High $323.59 | Professional | None (both parts) | $275.42 | $302.00 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $50,118.72 | Facility | None | $501.19 | $501.19 | $50,118.72 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $281.84 Median $323.59 Typical High $851.14 | Professional | 26 · Professional part | $281.84 | $323.59 | $851.14 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $426.58 | Professional | None | $295.12 | $331.13 | $426.58 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $295.12 Median $331.13 Typical High $426.58 | Professional | 26 · Professional part | $295.12 | $331.13 | $426.58 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,288.25 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None (both parts) Typical Low $263.03 Median $371.54 Typical High $660.69 | Professional | None (both parts) | $263.03 | $371.54 | $660.69 |
United Setting Professional Modifier 26 · Professional part Typical Low $263.03 Median $371.54 Typical High $660.69 | Professional | 26 · Professional part | $263.03 | $371.54 | $660.69 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $251.19 Median $251.19 Typical High $457.09 | Professional | 26 · Professional part | $251.19 | $251.19 | $457.09 |
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 $131.83 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $131.83 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 54 · Surgery only | $194.98 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.30 | $26.92 | $26.92 |
Where Maryland sits
The same service costs 23.4 times more in Colorado 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· 50th of 51
$324
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.