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 $45.71 Median $89.13 Typical High $128.82 | Professional | None | $45.71 | $89.13 | $128.82 |
CareFirst Setting Professional Modifier None Typical Low $44.67 Median $50.12 Typical High $50.12 | Professional | None | $44.67 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $85.11 Typical High $147.91 | Facility | None | $50.12 | $85.11 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $93.33 Typical High $144.54 | Professional | None | $41.69 | $93.33 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $239.88 | Professional | None | $107.15 | $131.83 | $239.88 |
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 $83.18 Typical High $186.21 | Professional | None | $38.02 | $83.18 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $186.21 | Professional | None | $91.20 | $91.20 | $186.21 |
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 $22.39 Median $22.91 Typical High $61.66 | Professional | 52 · Reduced service | $22.39 | $22.91 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $24.55 | Professional | 53 · Discontinued | $9.12 | $9.12 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $93.33 | Professional | 54 · Surgery only | $33.88 | $33.88 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $18.62 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.57 Typical High $12.30 | Professional | 56 · Pre-op care only | $4.47 | $4.57 | $12.30 |
Where Maryland sits
The same service costs 3.5 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· 47th of 51
$83.18
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.