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 $74.13 Median $112.20 Typical High $165.96 | Professional | None | $74.13 | $112.20 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | None | $72.44 | $81.28 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $107.15 Typical High $181.97 | Facility | None | $50.12 | $107.15 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $199.53 | Professional | None | $69.18 | $128.82 | $199.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $331.13 | Professional | None | $144.54 | $177.83 | $331.13 |
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 $63.10 Median $120.23 Typical High $263.03 | Professional | None | $63.10 | $120.23 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $251.19 | Professional | None | $128.82 | $128.82 | $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 $37.15 Median $37.15 Typical High $83.18 | Professional | 52 · Reduced service | $37.15 | $37.15 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $33.11 | Professional | 53 · Discontinued | $14.79 | $14.79 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $123.03 | Professional | 54 · Surgery only | $56.23 | $56.23 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $24.55 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $16.60 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $16.60 |
Where Maryland sits
The same service costs 3.2 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· 49th 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.