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 $54.95 Median $123.03 Typical High $165.96 | Professional | None | $54.95 | $123.03 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | None | $56.23 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $177.83 Typical High $776.25 | Facility | None | $107.15 | $177.83 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $125.89 Typical High $194.98 | Professional | None | $52.48 | $125.89 | $194.98 |
Kaiser Permanente Setting Professional Modifier None Typical Low $147.91 Median $177.83 Typical High $316.23 | Professional | None | $147.91 | $177.83 | $316.23 |
United Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,047.13 | Facility | None | $208.93 | $398.11 | $1,047.13 |
United Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $257.04 | Professional | None | $52.48 | $131.83 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $251.19 | Professional | None | $131.83 | $131.83 | $251.19 |
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 $27.54 Median $28.18 Typical High $83.18 | Professional | 52 · Reduced service | $27.54 | $28.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $11.22 Typical High $33.11 | Professional | 53 · Discontinued | $10.96 | $11.22 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $41.69 Typical High $123.03 | Professional | 54 · Surgery only | $41.69 | $41.69 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $24.55 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.62 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.50 | $5.62 | $16.60 |
Where Maryland sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 40th of 51
$132
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.