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 $58.88 Median $109.65 Typical High $147.91 | Professional | None | $58.88 | $109.65 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | None | $58.88 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $354.81 | Facility | None | $50.12 | $50.12 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $173.78 | Professional | None | $56.23 | $112.20 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $288.40 | Professional | None | $128.82 | $154.88 | $288.40 |
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 $53.70 Median $104.71 Typical High $234.42 | Professional | None | $53.70 | $104.71 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $218.78 | Professional | None | $112.20 | $112.20 | $218.78 |
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 $29.51 Median $29.51 Typical High $72.44 | Professional | 52 · Reduced service | $29.51 | $29.51 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $28.84 | Professional | 53 · Discontinued | $11.75 | $11.75 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $44.67 Typical High $109.65 | Professional | 54 · Surgery only | $43.65 | $44.67 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.91 Typical High $21.88 | Professional | 55 · Aftercare only | $8.71 | $8.91 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $14.45 |
Where Maryland sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 49th of 51
$87.10
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.