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 $53.70 Median $102.33 Typical High $181.97 | Professional | None | $53.70 | $102.33 | $181.97 |
CareFirst Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $70.79 | Professional | None | $51.29 | $57.54 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $112.20 | Facility | None | $50.12 | $66.07 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $102.33 Typical High $199.53 | Professional | None | $54.95 | $102.33 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $186.21 | Professional | None | $107.15 | $125.89 | $186.21 |
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 $56.23 Median $112.20 Typical High $229.09 | Professional | None | $56.23 | $112.20 | $229.09 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $165.96 | Professional | None | $102.33 | $102.33 | $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 $26.92 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $26.92 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $10.96 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $40.74 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $14.79 Typical High $15.85 | Professional | 55 · Aftercare only | $8.13 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.00 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.37 | $10.00 | $10.47 |
Where Maryland sits
The same service costs 2.8 times more in Alaska 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· 39th of 51
$102
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.