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 $64.57 Median $97.72 Typical High $107.15 | Professional | None | $64.57 | $97.72 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | None | $64.57 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $69.18 Typical High $602.56 | Facility | None | $51.29 | $69.18 | $602.56 |
Kaiser Permanente Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $158.49 | Professional | None | $95.50 | $117.49 | $158.49 |
United Setting Facility Modifier None Typical Low $64.57 Median $144.54 Typical High $616.60 | Facility | None | $64.57 | $144.54 | $616.60 |
United Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $177.83 | Professional | None | $60.26 | $97.72 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $165.96 | Professional | None | $117.49 | $165.96 | $165.96 |
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 $32.36 Median $38.90 Typical High $53.70 | Professional | 52 · Reduced service | $32.36 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $15.49 Typical High $21.38 | Professional | 53 · Discontinued | $12.88 | $15.49 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $57.54 Typical High $79.43 | Professional | 54 · Surgery only | $48.98 | $57.54 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.75 Typical High $16.22 | Professional | 55 · Aftercare only | $9.77 | $11.75 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.76 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.46 | $7.76 | $10.72 |
Where Maryland sits
The same service costs 3.4 times more in Alaska than in Virginia. 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
$81.28
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.