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 $41.69 Median $251.19 Typical High $331.13 | Professional | None | $41.69 | $251.19 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $46.77 | Professional | None | $42.66 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $602.56 Typical High $2,691.53 | Facility | None | $489.78 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $134.90 Typical High $512.86 | Professional | None | $39.81 | $134.90 | $512.86 |
Kaiser Permanente Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $676.08 | Professional | None | $288.40 | $338.84 | $676.08 |
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 $38.02 Median $281.84 Typical High $707.95 | Professional | None | $38.02 | $281.84 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $489.78 | Professional | None | $295.12 | $295.12 | $489.78 |
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 $20.89 Median $20.89 Typical High $165.96 | Professional | 52 · Reduced service | $20.89 | $20.89 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $66.07 | Professional | 53 · Discontinued | $8.32 | $8.32 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $31.62 Typical High $245.47 | Professional | 54 · Surgery only | $30.90 | $31.62 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $50.12 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $4.17 | $28.84 | $33.11 |
Where Maryland sits
The same service costs 6.8 times more in Iowa than in Nebraska. 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· 48th of 51
$105
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.